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<s>[INST] I am diabetic, hypertension , heart and asthmatic person and 60 yrs old. I am now taking glucored forte, jalra 50, insulin 30 units in am and pm, irovel 150, listril 5, korandil 10 and asthalin inhaler. Now I am able to have BP under control but my sugar level goes up to 170 or so in the morning (fasting) please suggest to me if i have to try anything else. Because of muscle pains i stopped storvas 10 and also my cholesterol level went down very much. My primary concern is to bring down the sugar level. My hb1a test was 8.5 which is of course high. I walk half an hour daily. Very careful in diet . Help me please, I want to know what to do to bring down the sugar level [/INST] Hi!!! Welcome to healthcare magic community forum... Uncontrolled diabetes is not an uncommon problem…. But allowing them to continue can lead to complications… A good diabetic control needs regular medication as strictly as possible, a good diabetic diet plan and weight losing exercise… You will have to re assess which of these is/are not working fine... Consult your diabetologist to modify the medications…. Work up a better dietary plan. You can take the help of a nutritionist in preparing a dietary plan if needed. Watch your weight… Physical exercise concentrating on losing weight is important Apart from this, sugars can flare up in times of stress and infection… Watch out for the stressors and infections.… Your sugars should come under control with small but important modifications… Hope this message was useful..... Thanks and Regards </s>

<s>[INST] yes! i really to know all about Liver abscess type B. thank [/INST] Thanks for the query I think u meant, Hepatitis type b, or rather hepatitis B. WHich is a more severe form of hepatitis but most of the times self limiting. It is transmitted through blood, body fluids including saliva but not urine and feces. Vaccination is available. Treatment is given only in forms where the viral load is high. Have a healthy living </s>

<s>[INST] I am a 21 year old white female who weighs 115 pounds and I m 5 4 . I have high amounts of microalbumin in my urine. I went to my physician where I have had two other urine tests done. The first test done 11/18/2010 results found my microalbumin levels at 45.3 ( and should be between 0-17 ug/mL) and the second test done 12/01/2010 my microalbumin was 70.8. Other than my vitamin d level being 16 and should be at least 100, they found nothing else and nothing in my urine (no creatine,etc.). What should I do and what could be the cause? [/INST] Hi. Welcome To HealthcareMagic An elevated microalbumin level is the first sign of kidney damage.Both diabetes and high blood pressure — among many possible causes — can damage the kidneys. I recommend the 24-hour urine test which provides the most accurate micro albumin results. Also some connective disease can cause proteinuria. I recommend ANA, RF. At the tests, consult urologist. Regards, Dr. Jagdish </s>

<s>[INST] About 5 months ago i noticed pain in my left hip at night when going to bed and would have to walk it out when getting out of bed in the morning. The pain would subside shortly after getting up. This pain has gotten progressivly worse and is constant, and has spread to my groin and front thigh. At times its a dull achy deep pain and at other times feels sharp in my hip and groin area with a deep throbbing in my thigh. I get no relief when lying down. The pain is still there and sometimes have to lift my leg with my hands to try and find a more comfortable position. The pain gets so bad at times that it causes me to limp. I've noticed the hip and groin area, more the groin, is becoming tender. Can you please help me out with this. I'm so tired of being in pain. [/INST] you can use hot pack to relief pain or moist heat use wet wash cloth and make sure its not too hot as it can burn you. stretching and strengthening exercise pelvic stability exercise .wish you a good health </s>

<s>[INST] Hello doctor, I am very sad and anxious most of the time. Lost motivation and most happiness, which has probably been gone for a while. Was on Zoloft for about five months, but it did not do anything. It was only on 50 mg/day so maybe that is why. I do not really want to cope with medicine because in the long run its just a mask for the way I feel. I am 23 years old and have a 10-month-old just some background. I quit my job because I did not feel mentally strong enough and would cry at work every day. I have been out of work for eight months and am scared to go back, which is also contributing to me being completely broke and contributing to me feeling worse about myself. [/INST] Hello. At your age, depression is reactive, means that there will be some stress factor. Are you feeling that life is no more useful or interesting, is there any suicidal ideas, have you lost pleasure in previously pleasurable activities? We have to increase the dose of Zoloft (Sertraline) and you should start some psychotherapy sessions. You should take part in social gathering and develop interest. Start talking to friends and relatives about your problem without thinking about what they will think. Start physical activities and keep yourself busy. Do one thing that you think is interesting. Avoid loneliness. Thyroid profile. </s>

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

<s>[INST] My 8 year old daughter has ADHD and a yeast allergy, skin problems, and some sinus infections. Her stomach hurts many time when eating also. I have noticed these all to be common in children with ADHD but I can not figure out the connection. Any ideas?Thanks Lisha [/INST] Hello,Welcome to HCM,Diagnosing of ADHD is a process that takes several steps and involves gathering a lot of information from multiple sources.There is no single test for ADHDYou, your child, your child's school, and other caregivers should be involved in assessing your child's behavior.We will consider how a child's behavior compares with that of other children the same age. As your child is having non specific signs and symptoms it cannot be related to ADHD.Your doctor can determine whether your child has ADHD or not.Thank you. </s>

<s>[INST] hello sir, i got married two months back. ques; after intercourse,while i am removing my pennis from my wifes vergina,there is some amount of semmen coming from my wifes vergina. ( usually i will remove the pennis after 1Ominutes of intercourse) i am having doubt that wether my semmen has entered in virgina or not. is there any problem. [/INST] Hi , How are you doing ?That is absolutely normal. Normal semen volume is 2-5 ml of which sperms is only about 0.5ml. Normally initial semen will be liquid, within few seconds , it will become thicken & then within 30 mins it will liquefy again. Inside body, on ejaculation semen will be liquid, it will be thrown onto the cervix, it will stick on cervix, for 30 mins during this time sperms will move in. Then rest of the semen has to fall of,If all the semen goes in, it will cause severe pain. So don't worry , you are okay. It's a misconception that all semen has to go in. After sex , remove penis, let wife lie down for 30 mins with pillow under hip , turned to one side. Then when she gets up , little may flow out, just wash the part that flows out with water. Don't use soap ro any chemical. They will kill spermsHope I have cleared your query, do write back if any more queriesAll the bestDr.Balakrishnan </s>

<s>[INST] When I get extremely upset, which is not often, I experience a tingling sensation on the back of my scull. Recently it happened but this time I felt it all over my whole body. Its not painful it just feels like the sensation you might feel if your foot falls asleep. It goes away when I calm down. What could be causing this? Am I having a panic or anxiety attack? Should I see my doctor and if so will he be able to find out whats wrong if it is in fact a physiological condition? I have an iron defficiency, but im otherwise in good health. [/INST] Dear thank you for sharing with us your health problem.Iron deficiency can't explain the symptoms you are experiencing.My recomandation is to explore thyroid function (T3,T4,TSH) if there come normal than you are experiencing a panic disorder.You should avoid caffein drinks as well as energic drinks and use camomile tea.If problem persist than you should consult your doctor to start medication.Anyway you have nothing to worry, it's fully treatable.Wish you all the best, don't hesitate to contact for further questions.Dr Eris </s>

<s>[INST] I am 42 and am 6 weeks pregnant. I was on Citalopram HBR 40 MG but stopped when my therapist put me on Remeron 15mg and Wellbutrin 300mg for depression and anxiety. I stopped celexa one day and started the wellbutrin the next. I was told to stop the wellbutrin and remeron the day I found out I was pregnant which was last week. I am so tired but when I go to bed in the evenings I seem to panic and get up and pace. I finally fall asleep on the couch in an upright position. Even then it is only for a few hours. I desperately need help with known what to do to sleep and to go back on my meds. My husband said if he would have known this we would have never tried for another one. We have a 3.5 little girl. I have to stay busy during the day so that I am not crying all day and I panic when there is nothing to do. [/INST] HI, thanks for the query. As such no drug is entirely safe in pregnancy & both mirtazapine (rameron) & bupropion (welbutrin) are no exception. Both fall under FDA category C i.e. to be used only if benefit outweights the risk. Hence you should consult your Psychiatrist & your Ob/Gynac doctor before continuing these medications. Secondly, considering your symptom profile; welbutrin is not a good choice as welbutrin itself causes flare up of anxiety & panic attacks. Single drug use Mirtazapine between dose 15-45mg per day (all dose taken at night) is an excellent anxiolytic & will take care of all your symptoms. As you are preganant & wont be safe to use SOS anxiolytic like clonazepam, etizolam; hecne also consult a Psychologist to learn relaxation exercise, cognitive behaviour therapy (CBT) where you will learn exposure & response prevention (ERP), autogenic relaxation training etc. Supplement all of this with yoga & pranayam & you will soon get well. Good Luck </s>

<s>[INST] I had a BP problem most of the time it remains in 140/90 range some time go upt 160/100..Doctor started Olemezest 40 once a nught daily..what could be the side effect..and can I control my BP with lifestyle changes..so that I will not use drug due to its side effects.. [/INST] hi dear. control of bp is very important .. its to keep your heart safe. yes you can control your bp life style changes..complete salt restrictionreduce your weight if you are obeseeat healthy ,lots of fruits and fibre deitkeep a regular check o your cholestroland most important regular cardio workout everydaymonitor your bp regularlypractice yoga or meditation.hope my answer helped you. thank you. please do rate my answer </s>

<s>[INST] Jitendra here, I have cold and cough, no sneezing, please help. [/INST] This is the season were people get this kind of problem.If you are having this occasionally then it is ok.you should avoid cold drinks,fried foods etc.Take light diet ,take steam inhalation with plain water or eucalyptus oil etc.For headache or bodyache you can have t.paracetamol and for sneezing etc,if you do not have any other medical problem you can take t.cetrizine. once daily.Take plenty of liquids,hot liquids like soup etc is better. If your problem is recurrent you should be having mostly allergic one and try to find out the cause of allergy,you can keep watch on and you will easily find out the allergen,in that case you need to take anti allergic treatment for long time.so need to consult your family doctor. </s>

<s>[INST] I have had a migraine for 4 days. I am also fatigued, feel chilled although I do not have a fever, muscle aches for a week, especially tight ham strings (1 above back of knee) that is so severe that it is hard to lift the legs to walk or get out of the car. And not sleeping well because it hurts to move [/INST] Hello, I have studied your case. Due to compression of this nerve root there can be tight hamstring.I will advise you to do MRI spine and EMG-NCV [nerve conduction study]. need to treat problem as soon as possible.Till time you can use supportive splint For these symptoms neurotropic medication can be started.I will advise to check your vit B12 and vit D3 level.Continue your migraine treatment.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care </s>

<s>[INST] Hello doctor,i have been experiencing with stomach pain soon after i visit Toilet.i had all the tests done and doctor told me that everything is normal and it is becoz of food this happened.but i get this pain once in a month.can you please suggest. the pain is severe and it will remain for 1 to 2 days. [/INST] Hi IN my opinion your symptoms seems to be related with intolerance foods.Try to notice which food make you sick and avoid using it. wishing you fast recovery dr.Klerida </s>

<s>[INST] My boyfriend had precum on his pants and touch it then touched my jeans to check if I got any on me. Then i grabbed my phone to looj it up. Afterwards, probably 10-15 minutes, I went to the bathroom checked my jeans again then preceding to urine and wipe. I can't remember if I washed my hand prior to urinating. Is it possible to still get pregnant. [/INST] Dear user, welcome to healthcare magic.It is very difficult to get pregnant such a way, but not impossible!It depends on many things, most important is if this happened at the time of your ovulation.If you are within 24 or even 72 hours, you can take the emergency pills. If not, wait for the time of menstruation.You may even have a blood test one week before the time of menstruation.I hope these words were useful to you.Good luck.Dr. Ahmed Bahaa. </s>

<s>[INST] hello, I TTC for one and half year. me and husband consult the doctor in husband report total sperm count is 102 million/ml, active motile 55% suggish 25% non motile 20% morphology 3-4 pus cell seen and for me my mensuration cycle is 28 days i am having bleeding only for 3 days. my last month period date is 12/11/2012 i want know when shall we make contact. i want to get pregnant this month. i was totally in stress for not having baby please help me [/INST] Hello, welcome to HCM, Your husbands semen analysis report shows normal sperm count (normal is >20 millions / ml as per WHO2009). Motility is also within normal unit (normal total motility is >40% as per WHO2009). Morphology is also within normal limit ( normal morphology of the sperm is >4% as per WHO2009). So, your husband's semen analysis report is quite normal. You should make contact within 22 to 30 th November. Regards. </s>

<s>[INST] in past i have suffering from hyroid but in present it is in normal range. Currently i m suffering from PCOD. From last 45 days i m suffering from low grade fever between 99 to 100. i am felling tired and pain in legs and body all the time. I concerned with the doctor in starting he suggest me test of malayria tified and urine test all are normals than he suggest me for chest xray nad full ultrasoung. only liver unlargement is come in report. he gave me antibioticfor 15 days and 14 injections of monocef(2 per day). i have face these painfull injection but still i have a temprature of 99.4 and some times 99.8. still i m feeling very tired nad pain in legs. i cant take proper bed rest because i am working. [/INST] Hi DearWelcome to the platform of Health care magic.Low grade fever for a long time, tiredness, bodyaches and liver enlargment all these symptoms points toward some chronic slow infection in the body like Tuberculosis .So in my opinion he should be investigated in terms of Tuberculosis as I suspected earlier. ( ESR,CBC, CXR,Mx Test.)All the possible acute infections like typhoid, malaria and UTI are already ruled out.Hope your query is answered.Thanks </s>

<s>[INST] i am 24,female with no medical complications.i take no medicines at present.i have good general health.i have been having abdominal cramp when i ovulate ever since my periods started.i have had it checked by a doctor and she said it is normal.i have seen that from the day of ovulation i have my next periods after 16 days.that is when i ovulate on the 11th day of my cycle i have my next period on the 28th day and when i ovulate on the 15th day then my periods start on the 31st day.in February i had my periods 7th feb but i had my next ovulation on 26th feb that is the 20th day of my cycle.therefore my periods started on the 13th march instead of on 6th march which was the 28th day.however i had a normal to heavy flow like usual with usual cramps for 4 days.i am very worried about this sudden delay.can i be pregnant even after having my period?i have tested with a home pregnancy kit and every time it has been negative.now i am having nipple tenderness(which i often get a week before my periods) and i am expecting my periods on 12th of april since i had my ovulation on 27th march(the ovulation cramp).please help me at the earliest.i am very worried and scared.thank you [/INST] Hi ,How are you doing ?At this young age with no complications, I can think of 2 possibilities.1. Pelvic Inflammatory Disease ( PID ) - infection arising from vagina , after sex. these infection can affect all the structures around uterus - this includes the tubes , ovaries & adnexa. 2. Endometriosis - can occur at any age. Bleeding from the uterus during periods is to the exterior , but a small amount of blood enters into the abdomen, through the tube. This blood forms clots & adhesions around the uterus.Both these conditions around uterus cause increase of blood flow to structures like ovaries , tubes , muscles & ligaments around uterus.So when ovulation approaches, this cause congestion & pain around the lower abdomen, thighs , lower back .Both need evaluation by gynecologist. PID needs treatment with anitbiotics & antifungals, both husband & wifeFor endometriosis- have Combined oral contraceptive pills cyclically will stop ovulation & will stop pain & progress of endometriosis. If you are seriously trying for pregnancy, do have tubal patency evaluated - HSG or SSG or Laparoscopy , do rule out tube block , which can hinder your chance of pregnancy.Hope I have cleared your queryAll the best </s>

<s>[INST] I am experiencing tightness in my chest behind the breastbone, a VERY pronounced lump in throat, and some uncomforatble tightness in my up back directly behind the pain from my breastbone. I tried taking TUMS but it didn t help. This has happened before, what could it be? [/INST] Do you suffer from allergies/asthma or are you a smoker. Your symptoms suggest that you could be having asthma for which you need to consult your PCP as he will examine you and prescribe you medicines accordingly </s>

<s>[INST] How can my family history of cancer effect my chances. My father died for Lung Cancer and also had prostate. My Mom had Colon but survived, my Brother died of Brain Cancer, two Aunts on Fathers side died of Breast Cancer and one on my mothers. Two uncles on Mom's side had lymphoma, one survived the other was murdered while still ill. Is there a TEST and does Insurance cover it? [/INST] Hello Friend,From the history, I understand that there is a strong family history of cancer in you. As a doctor, I have to admit that the incidence and chance of developing cancer is on the increase in such patients. But I would like to give you hope because I am a Homoeopath and in Homoeopathy, there is definite plan of treatment in such cases and such disease tendencies can be corrected using genetic constitutional remedies. An expert Homoeopath can very well remove the disease tendency in you and also keep you in perfect health preventing not only cancer, but any serious disease in future. Our case taking would suffice and there are advanced investigations which are not needed for a Homoeopath to prevent such disease tendencies. Best wishes to you. Do not get panicky which is an important cause for the precipitation of such serious diseases.Dr. C. J. VargheseHomoeopathdrcjvarghese@gmail.com </s>

<s>[INST] i keep on getting gum abscess in my upper gum. i got it drained one time, then i came back but busted on its own. Now I'm getting another one in the same spot and i feel it in my nose. Plus my left front tooth is a false tooth, i was wondering can that be the cause. [/INST] Hi,Thanks for posting the query, This could be due to infection in the tooth taht had spread to the surrounding tissue leading to the formation of gum abscess.I would suggest yout to get a thorough checkup done take an x-ray of the region.Go for complete mouth scaling and polishing.Take lukewarm saline and antiseptic mouthwash gargles.Take a course of antibiotics and analgesics.Take care! </s>

<s>[INST] dear sir madam pls let me know the simptons of bawasir bcs i feel some harshnes and my weight gone loose 2-3 kilo and also my digesting gone low but gentaly i m looking as its and not feel any pain or any unfittness pls tell me is it a simpton of bawasir and what i do in this situation thanks [/INST] Hi, symptoms of hemorroids are pain at time of defecation, bleeding in stool. feeling of something coming out from your analcanal etc, you should take more green leafy vegatable and plenty of water. avoid constipation. you can apply lignocain jelly at that area for pain relief. and if needed you can go for surgery for hemorroids.thanks for using health care magic. </s>

<s>[INST] I gag every morning and evening. I have to spit brown thick snot out every few minuets. Lately my throat is sore. I have a cough that is so bad I have blacked out once. I get dizzy all the time from coughing. I only sleep a few minuets at time before coughing wakes me up. Sometimes the coughing and sore throat goes away.The gaging to the lesser degree I had for 30 years. Lately the gaging is more often with some vomting [/INST] Hi thanks for contacting health care magic..Noted you have severe productive cough with sore throat....Here respiratory cause has to be ruled out...You could have bronchitis like infection or if purulent sputum there bronchiectasis also has to be ruled out...Chest x ray first done in your case to rule out cause...Your physical respi examination needs to be done with auscultation...You might given amoxiclav like antibiotic...For cough expectoration mucolytic drug like ambroxol given....Drink hot water which help in expectorating cough...If you develop chest pain and fever then pneumonia can be there...chest x ray reveal consolidation in it....If congestion more then antihistaminic might given.Steam inhalation useful....With keeping this in mind consult pulmonologist....Take care Dr.Parth </s>

<s>[INST] my 6 year old son has been unwell with a chest infection and nasty cough, this seems to happen at least one week out of every month. i took him to the dr to have him examined as i also was concerned that my son was complaining of a sore lower abdomen when coughing, (not urinating) and a sore to touch upper back (lung area). the dr did a urine test which showed positive for blood, no infection present, he ordered a blood test and second urine test for FBE; ESR;E/LFTS - M/C/S; ANA; CRP;. i have also noticed his inguinal lymph nodes, Retroauricular lymph nodes, and Retroauricular lymph nodes appear inflamed. what in your opinion are the concerning factors regarding the information i have provided. [/INST] HI, thanks for using healthcare magicLymph nodes respond to infection or inflammation in the area where they are responsible for drainage.The enlargement of the cervical nodes (retroauricular) is common with an upper respiratory tract infection (common cold or flu).They should return to normal size by 4 to 6 weeks after the infection provided he does not become unwell again during this period.The enlarged inguinal lymph nodes may indicate an infection in the thigh or groin area eg even a small cut.They can be monitored for any changes.The FBC would likely show an increase in WBC since he currently has an infection.It may help to repeat when he is well to see if it is in normal range.I hope this helps </s>

<s>[INST] Hi, I have a history of seizures. i have experienced most of the types them. For the past few years my meds have kept me perfect with no seizures at all. Last Dec. though, I had a major funky seizure in which the left side of my body went numb. Just that tingly feeling, not dead weight numb. Dr Peng says it was a seizure, because there was no sign of stroke . Since then, I have had migraines. I had a seizure tonight. I remember being in one place then woke up in another. I had a migraine before it had and a worse one after. I went to the ER. They gave me imitrex for my migraine. My question is: Why is my head going numb? Are they seizures? Or is the side affects of the 100mgs Topamax? [/INST] Hi, Thank you for contacting Healthcare Magic. You have both migraine and epilepsy. Therefore, topamax (topiramate) is a good choice for you, as it is effective against both the conditions. Topamax is a fairly safe medication and the common side effects are tingling and numbness of feet & legs and weight loss. Numbness of head is usually not due to topamax. It is either due to after effect of seizure (post-ictal state) or a minor seizure. Wishing you good health, Dr Sudhir Kumar MD DM (Neurology) Senior Consultant Neurologist Apollo Health City, Hyderabad </s>

<s>[INST] I was diagnosed with the flu last Thursday, was outbid on tamiflu and felt better and returned to my normal activities on Monday. However yesterday evening I started running a fever again and it has continued into today. Should I go to see my doctor again or is this still the flu just running its course? [/INST] Hello,Some advice that I can give to you is:- Take Ibuprofen drug for the fever three times a day- Drink liquid- Drink fruit juicesThe symptoms should continue for two to three days.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Dorina Gurabardhi </s>

<s>[INST] Hi Doctor, my eye went swollen last week after I had my lunch it was found out to be allergic to foods. Then the doctor gave me medicine to consume for few days. Few days later my allergy has gone but then my period still hasn't come. Does allergy delays period? [/INST] HI, thanks for using healthcare magicDelayed or irregular periods can be due to different causes including physical illness or stress.It is possible that your recent allergy or illness may have caused a slight delay in your period.The other causes of delayed period are: (1) pregnancy(2)emotional stress or illness(3)inadequate diet(4)extreme physical activity(5)abnormal levels of thyroid hormone(6)high levels of prolactin hormone(7)polycystic ovarian syndromeI hope this helps( </s>

<s>[INST] 30 year old male poor diet and very overweight. I was active and eating healthy and then stopped and began a poor diet. Now I am having chest pain/tightness for a week or more it is on the right side. What could this be? I know I need to change my diet, and stop drinking. I am not a smoker. [/INST] pain on right side can be due to muscle ache or nerve pain or any pleural disorder.you need to visit a pulmonologist who can request for a chest xray and diagnose the exact cause .for the timebeing you can take a analgesic like paracetamol after disscussing with a general physicianthanksfeel free to ask more questionsmay God bless tou with good health </s>

<s>[INST] i went to er today cause i woke up fine and in the mid afternoon my thumb and part of my palm became very bruised hurted and i had numbness and tingling they ran various test and sent me home they could not figure it out i am trying to research online what it can be they did xray of the hand [/INST] Hello, It would explain that your symptoms could be related to local inflammation. A pinched nerve can not be excluded either. For this reason, I would recommend performing nerve conduction studies and inflammation tests (PCR, ESR, complete blood count). 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] Hello doctor, I have a small little pimple and I am worried if it could herpes. I have not had sex in about two months and I always used a condom. I never had unprotected sex in my life, but I have seen this little red spot and I am worried if it can be an STD. [/INST] Hello. I have noted your concern and I have viewed the images (attachment removed to protect patient identity). No, it is not herpes. Genital herpes usually presents with multiple, grouped, fluid-filled lesions or genital sores which are quite painful. Regards. For more information consult a dermatologist online --> </s>

<s>[INST] My 10 year old nephew ate 4 bags of Jolly Rancher candies (25 candies per bag) over a two day period. He is now experiencing severe abdominal pain, cramping, constipation, abdominal pain when lifting his arms or twisting at the waist. Could the Jolly Ranchers be causing an obstruction? He had a CBC and his white count was not elevated. He has no fever, no nausea, and no loss of appetite. [/INST] Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. Yes. There is a possibility of bowel problems like obstruction or inflammation because of this abnormal candy consumption. He will need a X ray of Abdomen and an ultrasonogram study of Abdomen. Alternatively, he may have developed another abdominal problem (unrelated to candy consumption) like appendicitis, which is common in children. It would be wise to take an immediate surgical consult. Hope I have answered your query. Let me know if I can assist you further. </s>

<s>[INST] Hi... I have back ache and somebody suggested Kerala ayurvedic massage for good relief. Can this really help? Does anybody else got this done anytime and know if this helps? [/INST] Magnetotherapy treatment;- Place south pole of a med. power magnet for half an hour twice a day for10 days and drink magnetic water charged with both pole.however if yu are able to take acupressure and magneyotherapy treatment from a specialist you can get your back pain prob.resolve early. </s>

<s>[INST] My 7 yr old son has had pain on the lower left side of his abdomen for about 3 1/2 hrs this evening. Should I wait to see his Dr. tomorrow? [/INST] was he having any other symtom like vomiting diarrhoea if no then you can give him agnitundivati 2tab 2time. if other symtom are there then give him kutag vati 2tab 2tmes for 2days also give him light food then also if he dosent recover then consult for dr. </s>

<s>[INST] my 3-year old has an eczema like rash over her torso and extremities - I recently cut all nut butters from her diet a week ago and it improved but she still has flare-ups (much less severe now, though). Is there another dietary restriction I should try? [/INST] Hi...food allergy does not manifest like this. I feel this is isolated eczema.The trick of the management is keeping the skin moist and never allowing it to be dry. For this oil massage and lotions like Oilatum will help. Regarding cure options - eczema is a sort of allergy...allergies can only be controlled and can never be cured. But usually kids grow out of it...that is as the age progresses, they become better.Hope my answer was helpful for you. I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed)., </s>

<s>[INST] While sitting watching TV I got what felt like an electrical shock in my left arm from the upper area down to my fingers. It happened about 7 times within just a few seconds. It hit so hard I thought I was going to jump off the couch. Is this heart related or nerve? [/INST] Hi Thanks for contacting HCM. You had electric shock like sensation left arm and it has recurred 7 times in few seconds. Can you please specify your age/sex, comorbid health ailments and associated features like chest pain, jaw pain, sweating, neck pain & dizziness if any. As of now this pain could be because of NERVE (1st diagnosis), HEART (2nd diagnosis). Kindly revert back to us with more info so that we can guide you better. Take Care </s>

<s>[INST] i am four month pregent.i am suffering from ecoli infection and CMV infection .wat shouldi do to keep my baby procted from its adverse effect ,i am taking argiprime oral solution .i am 28 year ,5 ft 5 inch,weight 76 kg and had a missed abortion in june 2012 and again conviced in oct 2012. [/INST] Hello,Thank you for contacting HCMI understand your concern, I am Dr Arun Tank, Infectious Disease Specialist answering your query.E coli can be treated and has no effect on the baby. But CMV can have birth defect in the baby.CMV can cause retinitis and ear defect in resulting child.I advice you to take the cephalexin 500 mg four times a day for four days for E. coli infection.For CMV you can take gancyclovir. But take all above medication under your doctors guidance. Some cases of CMV has serious defect in children I advice you should discuss this with your treating doctor. For UTI I advice you should take plenty of water as much as you can take. IT will flush out your residual bacteria.Please wash your hand frequently in day time as it can also transmits the bacteria to the urinary tract.Maintaining hygiene is also a important part as it can also treat you equally as other antibiotics do.You can ask for further queries here on bit.ly/DrArun.Thank you,Dr Arun TankInfectious Disease specialistWe wish you a best health at health care magic. </s>

<s>[INST] I have had the implanon for nearly 12months, past 2 months I have had a period every week, only for a few days, it is dark brown, clotty, and causes terrible cramps, I have also noticed my stomach has been bloated (never normally bloated and not changed diet in any way) I am a healthy size 8 so can't put it down to lifestyle. I have been off food, with a constant sick feeling, but terribly thirsty. [/INST] Hello,Implanon is quite effective against unwanted pregnancy and its failure rate near about 0.1%. Here, you need to undergo one TVS scan to exclude possible miscarriage.Other reasons are side effect of implanon, hormonal imbalance, unnoticed uterine polyp/ fibroid, adenomyosis, DUB, pelvic infection etc.Following initial test, you need to consult with gynecologist for next investigation and suggestive medication. You may need to use other contraceptive method if implanon causes that.Maintain genital hygiene. Take healthy diet with iron supplements. Be well. </s>

<s>[INST] Hello, My father has a history of diabetes and blood pressure, currently he has elevated creatinine levels with GFR rate 20ml/min. This level of creatitinine has increased due to consumption of ketosteril tablets. How to reduce this creatinine level to get normal value. [/INST] Hello,Thank you for your contact to healthcare magic.I understand your health concern, if I am your doctor I suggest you that since your father has diabetes and high blood pressure. Such chronic illness can cause chronic damage to the kidney. Once the kidney function is compromised it leads to rise in the creatinine which is usually filtered by the kidney. To remove the creatinine out of body it is necessary to take the diuretics under your local doctors guidance.I will be happy to answer all your future concern. Thank you,Dr Arun TankInfectious disease specialist.Wish you a best health at health care magic. </s>

<s>[INST] My 5 month old son has had frequent bowel movement for last 2 days, the frequency is about 6 to 8 in a day. he is on mothers milk only and tends to pass bowels within 15 mins of feeding.We are giving him doctor prescribed Relyte soln and an antibiotic.Kindly suggest hen can we expect him to recover.The stool is yellow n not too watery. [/INST] if the stool is not watery and your child is passing urine adequately and the child is playful the infection is not very serious. with antiboitcs and ors your child should recover in 3 to 5 days. continue to breast feed and wash hands well after changing the diaper. </s>

<s>[INST] A friend had psoriasis for over 20 years. Shje is now 57 years of age. 12 years ago she began to suffer from arthritis. Doctors merely said it was psoriatic arthritis. Over the last two years her kidney became diseased (stage 4). It was then that a doctor said she was most probably suffering from yeast/fungal infection. I was wondering if she could be treated for the yeast/fungal infection by way of starvation with saline drip and antifungal. Of course if this is possible it will be done in a hospital. Once the yeast infection is cleared, the kidney disease could be addressed. Your views under no obligation or lialibility please. [/INST] Hi, Fungal infection of kidney is difficult to treat and antifungals are the choice of treatment. She can consult a nephrologist and get evaluated. Hope I have answered your query. Let me know if I can assist you further. </s>

<s>[INST] im 18 weeks pregnant, and i have just started passing bowel movements about 4 days ago, from where ive been really constipated. So i went and thought i had to pass a bm and it was very little but when i wiped i had blood all over the toilet paper? im scared [/INST] Hello, and I hope I can help you today.Constipation is very common during pregnancy. It is caused both by the hormones of pregnancy and some of the ingredients and prenatal vitamins.When your stool is very hard, occasionally it can cause some bleeding around the anus if a particularly large stool is passed. In addition, hemorrhoids, which are common cause of rectal bleeding, can develop during pregnancy. These are not harmful and can be diagnosed by an examination by your obstetrician.I suggest that you make sure that you drink lots of water and I recommend that you buy a stool softener or other mild laxative as these are safe to use during pregnancy. Applying petroleum jelly or hydrocortisone cream using toilet tissue after a bowel movement can help lubricate the area to help stool to pass.If you continue to bleed every time you pass stool or the bleeding becomes heavy (like seeing blood in the toilet when you have a bowel movement) it may need further investigation.Otherwise, I would take a stool softener or laxative and discuss your situation with your obstetrician at your next appointment.I hope I was able to adequately answer your question and that my advice was helpful.Best wishes for the rest of the pregnancy, Dr. Brown </s>

<s>[INST] Hello,I have had a weeze and deep cough for 1 week and 4 days,at first nothing would come up at all just a hollow cough. Once mucus started coming up it was clear but very sticky,now I have a mucus like discharge as well...I am female. Its been in both panties and urine as well. I am also experiencing a constant pain in my lower left side that feels sort of like a cyst burst [/INST] allergic coughwheezing and dry cough is sign of allergythe mucus come from sinuses if it is clear it means not infectiveuse antibiotics specific for sinus 3 daysantiallergic bdbronchodilator syp t contrl wheezing and coughuse for 2 week </s>

<s>[INST] I have a 20yr migraine history I also have since Aug had a problem with my blood pressure out of control. I have been checked for heart problems with a clear outcome. I am now on 2 bp meds and a beta blocker taking 6 pills a day bps are anywhere from 120s-185 bottom #70-95. [/INST] Hello and thank you for using HCM.I carefully read your question and I understand your concern .I will try to explain you something and give you my opinion.You should know that when we treat hypertension our goal is to keep mean blood pressure values below 140 / 90 mmHg.A person might have high value during emotional and physical strees so its mandatory to judge on mean values.To judge if it is necesary to change treatment, rise dosage or add another class its necessary to judge in mean values.If I was your treating doctor I will recommend some examination like a cardiac echo to evaluate heart function and walls, a full blood analyze to chek electrolyte and the most important one holterblood monitoring to evaluate your values during day and night.After all this we can judge what to do with your treatment.I will also give you an advise.As you suffer from migraine, be careful and try to avoid analgesics like brufen becouse they rise blood pressure even more.Hope Iwas helpfull.Best regards, Dr.Ervina. </s>

<s>[INST] Hi. My 11 year old daughter has a temperature for 5 weeks now accompanied by a headache which is constant. She has had normal bloods. Normal USS & normal MRI . I am so worried. Usually she is full of life doing cartwheels but now she has a general malaise. We returned from Turkey on the 19th April and she became ill 4 days later . Many thanks . [/INST] Am happy to help yo. . I need some more details like which place you belon, any jaundic, organomegaly. ChChild rrequires clinical examination and some more blood tests. This is PUO. Kindly consult your near by pediatrician.Dr.surendra </s>

<s>[INST] my husband needs a colostomy reversal and hernia repair but has had sexual dysfunction problems that could be related to his original sigmoid cancer 5 years ago - yes he should have had this operation at least 4 years ago but we had to sell our home and various other problems arose. He was on life support for a while and before this was a normally functioning man of his age [/INST] Hello, Yes, it can be related to cancer. Long term diseases can cause loss of libido. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr S.R.Raveendran, Sexologist </s>

<s>[INST] Sir I am 20 year old boy,from the age of 18 I am eating my hairs from berd,from ibrows,from eyelashes and from other areas of my body,i feel tensed if I don t do the ritual,please help me,at present I am suffering from low confidence,kow self esteem,worse social image,please suggest me the treatment [/INST] Hello,Treating the disorder of trichophagia is similar to the treatment of other impulse control disorders. The disorder is believed to causes by a chemical imbalance in the brain and can be treated with a combination of anti-depressant drugs and psychotherapy. I suggest you consult a psychologist or psychiatrist in person for treatment. Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. K. V. Anand </s>

<s>[INST] I AM ON THE 2ND DAY AFTER A BREAK UP.WE HAD BEEN TOGETHER 3 YEARS , I CANNOT SLEEP, I AM TERRIFIED OF BEING ALONE THIS WAS ALSO PARTLY TO BLAME FOR THE BREAK UP, I AM CRYING, MY STOMACH IS MAKING CRAZY NOISES , I AM HAVING PANICK ATTACKS AND BREATHLESS.ITS BAD AND IM DESPERATE TO KNOW WHAT WILL MAKE IT GO AWAY ? [/INST] DearWe understand your concernsI went through your details. I suggest you not to worry much. I do not think you are having panic attacks. The symptoms are emotional desperation. You are deeply in love and the love shows out on the event of break up. Do not think negative. These are normal. Here you have not made clear the break up details. Is it after marriage break up or bachlor-love-affair-break up? The second case is more emotional because of the perception attached to it.In any case, human being cannot be always disappointed. They come out of the cocoon of disappointment sooner or later. That is the pattern. Then, I assure you, you cannot have mental illness just by this break up. But you should start interacting with others. Vent your emotions with your friends and relatives. Be active.For more psychotherapy techniques, You can post a direct question to me in this website. Include every detail as much as you can. I shall prescribe some psychotherapy techniques to control your condition. I am sure that the techniques should be a success.Hope this answers your query. Available for further clarifications.Good luck. </s>

<s>[INST] Hello I'm 28 year old male. I have been having back pain in my lumbar spine for about 3 years. It is 24-7 on going mri shows annual tears at l3-l4 and l4-l5 also. i just had a discogram and it did recreate my pain at these levels. I have completed 2 rounds of PT and done 3 injections prior to getting my discogram done. Following my discogram I recived Pulse Radio Frequency on the levels creating pain. I know theres not a lot of research on Pulse Radio Frequency. I am unclear if its supposed to work right away or if it takes time. I know that it may not work at all but am hope full. Right know I would do anything to get this ride of this back pain. I think my next opion is surgery. I've been off work for a month and was hopeing this will help so i can go back. If not Im going to switch my antidepressant to cymbalta and maybe see about getting some kind of pain med for brake through pain so i can go to work and keep my insurance long enuff to help pay for the suregery. Sorry for my post being so long. Its been a long road. Thanks for any help. [/INST] HiThank you for asking HCM. I have gone through your query. Back pain and sciatica associated with disc herniation can last for 1 month to 6 months. With muscle relaxants like cyclobenzaprine and pain medications like tramadol i usually use in my patients to control the symptoms. Physiotherapy and muscle strengthening exercises will speed up your recovery. So you can wait for a 6 months duration before considering surgery if there is no serious neurological deficits. Hope this may help you. Let me know if you have any further queries. </s>

<s>[INST] Hello doctor, I have had this lump on my hard palate for about three months now. It is located near the middle line and a few millimeters to the left. It is about 2 x 2 mm in size, pretty round and it does not hurt. I thought this might be torus palatinus. But, I heard that this torus is mostly symmetrical and my lump is only on one side of the palate. In the picture, it looks a little red because I scratched it with my finger nail. It was just a little bit more red than the other side of my palate as I scratched it. So, what could this be? I am scared that it might be some kind of cancer. [/INST] Hi. Torus palatinus. If torus palatinus, then it is completely harmless and require no further investigations. Revert back with the answers to the above questions to a dentist online.---> </s>

<s>[INST] My sister in-law is 11 days away from her due date. Today she was admitted to the hospital and put in the labor and delivery room because she was puking up blood. Not too long ago (a week maybe) she fell down and didn t want to go to the hospital because she said she felt fine. Is there anything wrong with the baby and is there anyway that those two could be tied together? [/INST] Nasal bleeding is common during pregnancy due to its related vascular changes and vasodilation of the blood vessels of the nose. Since this does not seem to be the case we should consider that blood is coming from the stomach or lower respiratory system (lungs). It is never NORMAL to puke or cough blood during pregnancy. TBC and gastroesophageal causes of bleeding should be sought. She now is in the hospital and MDs there should be taking care of that </s>

<s>[INST] I have an little ball of gum tissue in the back of my mouth on the bottom left corner wear my wisdom teeth used to be its the same color as the rest and I just noticed it yesterday it feels like there is food in my mouth it moves around but isnt tender and doesnt hurt what cud that be? [/INST] HelloWelcome to HCMI read your query. You have mass of tissue where your wisdom tooth used to be. Since you already got your wisdom tooth extracted so I will advice you to get your opg xray done, which will reveal the final diagnosis. Mean while you can do warm salime gargle 3 to 4 times a day.Thankyou </s>

<s>[INST] ihave caevicle fusion,have recently been falling due to lack uf blood to my brain,now I have swellimg in my left side, and kidney pain,also.h\knee pain.elbow pain, and neck pain on ledt side. this is where I have 3 inch bone surpes,at C4/5/6 with deteation of t1/2/3 [/INST] hi,thank-you for providing the brief history of you.As mentioned by you about the brief history I will advice for thorough neuromuscular assessment.Post which undergoing physical therapy will help you to reduce pain with Therapeutic ultrasound therapy. Also later on exercises will be taught to improve the Strength of the muscles to keep the joint spaces maintained. Following this you can perform exercises @ home to maintain the strength in the muscles.regardsJay Indravadan Patel </s>

<s>[INST] hello sirmy self kiran .... recently i got engaged wid one of ma fren...we met for 2-3 timesnd d guy has told me dat he has got some premature ejaculation problem...nd he says like i should take dis condition as if he is on d worst stage....can u plzzz tell me...wat can b d conditions bad 4 melike can i get pregnent if i get married wid himcan v njoy totally sex married life or notreallly sir i will b very thnkfull to u....if u can guide me....thanx a lot [/INST] Hi, Premature ejaculation is uncontrolled ejaculation either before or shortly after sexual penetration. It happens with minimal sexual stimulation and before the person wishes. Most cases of premature ejaculation do not have a clear cause. With sexual experience and age, men often learn to delay orgasm. Premature ejaculation may occur with a new partner. It may happen only in certain sexual situations or if it has been a long time since the last ejaculation. Psychological factors such as anxiety, guilt, or depression can also cause it. In some cases, it may be related to a medical cause such as hormonal problems, injury, or a side effect of certain medicines. In many cases premature ejaculation gets better on its own over time. Treatment may not be needed. Practicing relaxation techniques or using distraction methods may help you delay ejaculation. For some men, stopping or cutting down on the use of alcohol, tobacco, or illegal drugs may improve how well they can control ejaculation. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Iven Romic Rommstein, General Surgeon </s>

<s>[INST] I am currently suffering with sinusitis which has given me jaw ache on the right hand side of my face and I feel a slight deafness in my right ear. I take Diovan 40mg and 75mg asprin daily to manage slight hypertension so am unable to take any over the counter sinus medicines. I am using an Olbas inhaler which keeps my airways clear but otherwise do not seem to be getting much better. [/INST] Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.I suspect that you are having otitis media infection.In this infection ear drum is ruptured because of it you can't hear on that side.Jaw pain is because of the inflammation on that side.I advice you to take cefixime, paracetamol and chlorpheniramine maleate under your doctors guidance.Please do take other drugs regular. If you are taking the steroid in inhaler please review it with your doctor because it causes immunosuppression.Please maintain good hygiene as it is equally important in clearing infection.Ruptured ear drum can be repaired with surgery. So if yours have ruptured than you can repair it.I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM. </s>

<s>[INST] i have had hip pain for a year and a few months now and and its making my pelvis hurt and making my leg feel numb .its making it difficult to walk, sit and stand up i m a 15 yr old basketball player and first time cross country runner so dont know if that has anything to do with it please help. [/INST] Hello, As a first line management, you can take analgesics like paracetamol or aceclofenac for pain relief. If symptoms persist better to consult an orthopaedician and plan for an MRI scan. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician </s>

<s>[INST] I am 44 male with high blood pressure on medication, I have been exercising and losing weight for over 2 1/2 months. Lately i have had bad smelly gas and chest pains. The pain moves from left breast to middle of chest and now my neck is getting sore all the time/ [/INST] Thanks for your question on HCM. By your history and description, you are mostly having GERD associated pain. But better to rule out cardiac cause first because you are hypertensive. So get done 1. Ecg 2. 2d echo 3. Stress test. If all are normal then you are mostly having GERD. It is due to laxity of gastroesophageal sphincter. Because of this the acid of the stomach tends to come up in the esophagus and cause the symptoms of Central burning chest pain and gaseous feeling in stomach. So avoid stress and tension. Avoid hot and spicy food. Avoid junk food. Start proton pump inhibitors. Don't worry, you will be alright. </s>

<s>[INST] can fingering soon after ejaculation lead to pregnancy? This is a situation where I am still in dilemma as to whether my hands had sperms at the time of fingering which followed soon after ejaculation. It's been a moment back and so kindly suggest in the given situation which contraceptive pill would be safe to use and would have least side effects with gaining of weight or others and the duration and timeframe within which it should be taken? please suggest [/INST] Hi, of course the possibilities of pregnancy are very less, but not completely abscent. In this case consider it as a routine ejaculation. and consult a doctor for advise. There are products like unwanted 72 etc to prevent pregnancy. Thank you. </s>

<s>[INST] 5th incident this month. early morning hours, sharp heavy pressure chest pain when turning from left side of sleep unto my back. center of my chest,can hardly move,almost like a paralysis...but painful. I hold and push on my own chest to help relieve pressure,squeezing,pain.Thought it was a heart attack? [/INST] Thanks for your question on HCM. I can understand your situation and problem. We need to get done ecg and 2d echo first, to rule out cardiac cause. If both are normal then no need to worry for cardiac cause. GERD (gastroesophageal reflux disease) can also cause similar symptoms. It is due to laxity of gastroesophageal sphincter. Because of this the acid of the stomach tends to come up in the esophagus and cause severe central chest pain. Better to follow these steps for better symptomatic relief. 1. Avoid stress and tension. Avoid hot and spicy food. 2. Avoid large meals, instead take frequent small meals. 3. Start proton pump inhibitors. 4. Go for walk after meals. Keep 2-3 pillows under head in the bed to prevent reflux. 5. Avoid alcohol and smoking if you have these habits. Don't worry, you will be alright. </s>

<s>[INST] I have a lump on my neck that grows and shrinks. My doctor thinks it's a sebaceous cyst but after looking it up online it doesn't seem to have the symptoms of one. When it grows it is very painful but when it shrinks it's fine. It may be a coincidence but I think it grows with heat. I've had it for about 2 or 3 years now and it has always done the same thing. Just recently it's grown even bigger to the point that the bump is very noticeable. Before even when it grew you couldn't really see it clearly, just feel it. [/INST] It may be a lymph node which grows with some local infection like cough and cold and subsides as the infection goes off. You need to have a broad spectrum antibiotic for 7-10 days to reduce it. Usually, a sebaceous cyst may also present the same ways but it usually has a black punctum or dot some where on the bulge. If it is in the midline of the neck, it may be a dermoid cyst which may also get infected and grow in size. </s>

<s>[INST] my sister very recently has been investigated because of low hemoglobin and iron. they discovered some sort of genetic issue that may be in our family (alpha ?) can that lead to lymphoma? I recently received tx for lymphoma and am quite concerned for my kids and grandkids, especially since my son in taking Remicade q 6 weeks, which makes him more at risk for it too. All these together make me quite anxious for their increased risk. do you have any information or links i can further research? [/INST] Hello, Welcome to HCM, I am Dr. Das Look, your sister is suffering from alpha thalassemia most possibly. It is a defect in hemoglobin synthesis but is minor in clinical course than beta thalassemia. So, do not worry at all. It is not a lymphoma. But her spouse should be tested by HPLC study to rule out any chance of homozygousity or dual heterozygosity in their children. Hope this will become helpful. Regards. </s>

<s>[INST] For the past 20 days i'm taking prolomet 50 as my doctor told me that i've BP (160/100). But my main concern is that generally i feel nervous,anxieted the moment i enter the doctor;s room and i'll be sure that my BP has rised. The moment i come out of the room i feel relaxed. The pulse rate during the check up was 110 BPM (as my doctor told) and after taking the tablet my pulse is 55 BPM. Is this okay to take these tablets and need your advice. [/INST] hello,I have gone through your query.Thanks for using HCM.If you have high pulse and BP reading during office visit to doctor you may have white coat hypertension.I suggest you to get your ambulatory BP monitoring done .It will give you reading of BP at diff interval for 24 hours.Depending upon you may take decision to start medicines.My best wishesDr.Rajesh Teli,MD. </s>

<s>[INST] My 16 year old daughter has taken a few medications for depression since November . Before taking these medications, she excelled in school and in sports, being selected as a top basketball players inher province. In November, she came to me ( her mother) saying she was having suicidal thoughts, but no plan to hurt herself. Since this time she stated on Celexa 10 mg - no effect on her sadness, but she noticed it was harder to concentrate at school. After one month, she was switched to 20 mg - still no positive effect on sadness. Her marks at school were starting to drop and she had increased nausea and difficulty sleeping. The dr. Then added Welbutrin, this was not good for her, within days she was having severe nausea, vomiting, stomach pain ad very irritable. The Welbutrin was discontinued. She was then switched to citaloprex in early April- this med was not helping her sadness either. Two days ago, she experienced an episode ode increased depression and asked me to take her to the hospital as she didn't trust herself. We saw the dr. In the emergency dept and he switched her mess once again. She has been taking fluoxetine 20mg and methylphenidate 5mg. Today, she is experiencing flu-like symptoms such as cough, stuffy nose, severe aches starting at lower back and extending to legs and a burning sensation in throat and heart area. I am not sure if she has the flu or if these are side effects from the new medication. She had the cough and stuffy nose two days before she started taking the new mess. Not sure if we try to ride out the symptoms or if these symptoms merit the attention of a medical doctor. [/INST] Hello Depression is pervasive sadness of mood with low energy and lack of interest in day to day routine along with a lot of other somatic symptoms. Antidepressant such as Escitalopram or citalopram usually takes about 4-6 weeks to show full effect. They don't work if taken as SOS basis. She has been recently started on Fluoxetine and Methylphenidate and both are good drugs. Fluoxetine is good antidepressant and it also don't cause sedation so it will help in improving concentration. Methylphenidate is a stimulant drug and it improves concentration. As she is experiencing the symptoms as flu like illness and restlessness along with aches most likely these are due to Methylphenidate. The symptoms will go in a week or two. It is a stimulant drug and it causes activation and may precipitate anxiety. If symptoms persist then visit a Psychiatrist. Thanks Dr. Seikhoo Bishnoi, MD </s>

<s>[INST] Hi doctor, I am 18 years old. I have been suffering from a few health problems for many years. I think that I have some problems with my testicles. They hang low, feel sensitive, and sometimes they pain (mild) when they get any push. Two months ago, I also had an ultrasound and color Doppler. Everything was normal. I also have some urinary problems. Every time I pee, some amount of urine get stuck inside my urethra and sometimes after shaking 1 or 2 drops comes out. I feel uncomfortable with this issue. As my testes hang low, I cannot walk without pushing them, and I feel tenderness there. I do not wear underwear in the evening hours. I have one doubt. Can urine go into the testes? When I cough or sneeze, I feel my urine is dribbling into testes. Do I need an ultrasound of scrotum? I had an ultrasound of kidney and abdomen before a year, which showed that everything is normal. I just had mild cystitis a year ago, and now I have this urine problem. I also get some sticky, watery substance under my penis and above the testes.Sometimes it smells bad. Also, I am getting nightfalls once in every two days. I am uploading the images of my report and prescription for your reference. [/INST] Hi. For further information consult a urologist online --> </s>

<s>[INST] my absolute eosinophils last may 25,was 611,do I need to get worried about that counts, I am 52 y/old 164lbs,5"6 in height. I have a maintenance medicine for my high blood and I had a triple heart bypass last 2008 since then I've been drinking this med. losartan/hctz 100/12.5mg,crestor20mg.,glipizide ER 5mg.,niaspanER500mg.,allopurinol300mg.,metoprolol succ ER25mg.(new additional)and colchicine when my gout flare [/INST] Hi, dear.You have mild eosinophilia. It is not a cause of big worry. still you should search the cause of eosinophilia and take treatment accordingly. There are many causes of eosinophilia like allergy, asthma, hypersensitivity, parasitic infection. Just investigate for that and take treatment according to your diagnosis.Its not a serious disease. So don't worry. Just be relaxed.Thanks for using health care magic.Wish you a very good health. </s>

<s>[INST] Hi Dr. Prabhakar,My mother is asthamatic for more than 15 years and she was taking Seroflo 250mg Inhaler and she was not having the Asthama problem for sometime now. since last 6 months, he was getting severe headache and she was suggested to take BP tablets. The doctor priscribed Aten 25mg for her. But I got to know from our family doctor that the prescribed tablet "Aten" will actually worsen her Asthama problems and he suggested to take Losar H 25mg. Now i am actually in a delima for to which tablet she should take. Can you please help?Regards,Pradeep. [/INST] Hello Pradeep, Welcome to HCM and thanks for posting your query here. Bronchial Asthma is due to narrowing of the bronchial airways. As it is more than 15 years it is a chronic disease. What was her BP? That you need to check. BP is not only a single cause for headache. Before starting the therapy her pressure levels should be checked. Aten is a beta-blocker. Definitely it aggravates the asthmatic problem. It lowers the pressure levels and the other action of the drug is constriction of bronchial smooth muscles. This complicates the asthma problem. Hence it is contraindicated in asthmatic patients. Losar H can be used without any contraindications in asthmatic patients. Hence please check her BP levels and continue the medicine. Hope this is helpful to you. Regards </s>

<s>[INST] What is it when suddenly your entire waist is wacked with pain, and attempting to stand you get severe pain also, and sitting is the same. Goes on 24 hours hurting like crazy and sometimes very severe even when sitting? I pray you will be able to enlighten me relevant to the causating factors involved? [/INST] hi,Thanks for providing the brief history of youSince you mentioned that the pain is constant and it is making it difficult to stand, sit, turn etc you need to first lye down on your stomach and keep a hot water bag wrapped up in a towel to provide deep heating, by which muscle spasm comes down.If you do not have any pain in the hip, thigh, calf or feet than you should not worry much. This kind of pain occurs due to either muscle spasm in the lower back or sacro-iliac-joint dysfuntion. Usually it take 5-7 days for inflammation to come down if proper rest is taken. In case if the symptoms dont come down for a safer side you can take an X-ray or an MRI for finding any soft tissue injuries.If the pain is slowing down then you can proceed to meet a physical therapist who can teach you some core strengthening and spine strengthening exercises which will help you more.Never ignore a simple back pain also, as we never know how big it can be or may become. Some times due to ignorance the soft tissue injury becomes big and pain level raises.Also the core muscles and spine muscles are in constant use all the time and their strength is more important for future to avoid any major injuries.I hope i have answered your query.feel free for any more queriesRegardsJay Indravadan Patel </s>

<s>[INST] after 6 year marriage i have no child. my semen report is given.is this enough. volume; 2ml 50miln/ml active; 55% slugish;25% dead; 20% is this report enough for a baby age; 33yaers weight;92 kgs height;5.11 feet means 5 feet 11 inches [/INST] Hi, you didn't mentioned how was the morphology of your spermatozoa, if 15% or above is of normal form it is enough. One more thing you didn't mentioned is presence of leucocytes(white blood cells) in semen, if those are less than 1 million/ml it is good. Your remaining parameters are normal. If you give the details of your wife's medical tests if done and any previous procedures undergone we can discuss thoroughly about your problem. thank you </s>

<s>[INST] I have been having pain and extreme tenderness to the touch on the right inside of my right forearm just below the elbow. I have only experienced this type of pain and sensitivity once before, and that was about 30 years ago but the pain was in my big toe, and it was diagnosed as gout. I also have bursitis and arthritis in my hips and shoulders, but this is the first time I’ve ever had this pain in my arm. [/INST] Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. Yes, it is possible that gouty arthritis of elbow or tennis elbow or pulled muscle etc. Until examination is done it is difficult to say what it is. Take rest , use cold compression and painkillers support. If symptoms not improved please consult your orthopedician, he will examine and treat you accordingly. Hope I have answered your query. Let me know if I can assist you further. </s>

<s>[INST] Had pnuemonia after several rounds of antibiotics and steroids my breathing is fine but I ve had a feeling of a lump in my lower throat and a cough for several weeks after went to doctor and said my throat felt fine and said it was possibly due to allergies/post nasal. [/INST] Hello dear,The symptoms as mentioned in your post suggest that you might be having Allergic tracheo-bronchitis.Examination of the throat using a laryngoscope and X ray of the chest will be helpful in clinching the diagnosis.Management includes:1.Antihistamine preparations like Allegra & Cough expectorant syrup for symptomatic relief.2. Montelukast preparations- used as a maintenance therapy to relieve symptoms of seasonal allergies.3. A course of antibiotics may be taken to prevent secondary bacterial attack.4. Maintain adequate hydration & take a healthy balance diet.5. Also make sure that you are well protected from cold, dust & other allergens.Wishing you a good health.Take care. </s>

<s>[INST] I am taking elleste duet 1mg for the first time I felt really great on the white tabs but not a good now on the green tabs. however I feel much better then I did before taking them. I just want to know can you have weight gain while taking the green tabs as when I first started on the white ones I felt I had lost some weight. Im hoping the slight weight gain is temp and will even out once taking them for a while. Regards XXXX [/INST] Hello,Like other drugs elleste duet, which is a combination hormone drug, has some side effects and one of the most common side effect is weight gain. The weight gain is primarily due to fluid retention. Let me also assure that the weight gain is not permanent and will be there only till you take the tablet.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Prabhash Verma, General & Family Physician </s>

<s>[INST] hi .. i had some unsafe sex during periods. it was 2nd last day of period.. n after over of periods i took ipill i mean withing 48 hrs. but after 1-2 day i m sfrng frm stmch pain n after 4 days ie frm yestrday i got vaginal bleeding which is going on till now. wht to do ? is it consqnce of pill? or pregncy sign? nything serious? [/INST] Hi,Having unprotected intercourse during menstruation does not cause pregnancy as it is safe. The bleeding you are experiencing now is most likely due to the emergency pill usage. The bleeding should usually subside as the effect wears off. You may expect your next one or two cycles to be disturbed. If you do not attain your next period even after 10 days after it is due, you should consult a specialist for further suggestions. Take care. </s>

<s>[INST] Hi... My 3 yr old son feels lot of itching around his anus and complains of Stomach ache sometimes. His Anus is usually reddish and looks like having cracks. he had pinworms around a yr back but have never noticed them again. Though I have noticed twice, some small black thing on his anus recently. Pls help [/INST] Give anti worm syp albedazole 10 ml stat and maintain hand hygiene. You may apply coconut oil at anal area </s>

<s>[INST] Right kidney measures 81 x 41 mm and shows a calculus of size 7.6 mm at PUJ with upstream mild hydro nephrosis. I am taking Burberis Vulgeris for 2 months but no positive result. Regular feeling of Burn and Pain in lower right abdomen and right lower back. Please suggest effective treatment. [/INST] Hello, Lower back ache is due to the kidney stone itself please drink plenty of water and see an urologist for the same. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Haleema Yezdani, General & Family Physician </s>

<s>[INST] Hello and thank you dear Doctor, I am suffering daily with anger and rage and I blame constantly and I cannot tolerate this shorterm condition. The negative apparent does make me feel physically sick and chest trauma I feel every day. I am fairly healthy, I smoke like hell and I enjoy it, there, at every turn there are the worst assaulting us continually, no wonder. I must remain positive though and that does feel easiest. I forget to for example: focus on my breathing and soon I am raging again and quiet at night usually, or I forget my entire plan to make it all easier on myself in all other way s, thankyou. I have formation that the police would like to know about but that too make s me rage terribly while doing that, so how do I get out of this. Last night a very sound made me turn over , it was the sound of the metal plasty turn of the latch on the window and I realized that i did not have to feel black and hard, anger terrible thing s, that men are accused of and illegally I think, thank you. My Father is my parent then I/We earn a few minute s, thank you. Alleged Anne said to quash the anger and that too remind s me of her . So I do not turn our Father out and I care not for you. Jennifer gone and done that yesterday, thank you. OUr child once said that she loved dearly the Germany counterpart and that I kept quiet because we feel easy for everyone. Nazi s, Apparent s, Jew s Etc. We do not know them we deliver them, thank you. That is my child, young and easy. Thank you Doctor Mr. [/INST] DearWe understand your concernsI went through your details. I suggest you not to worry much. Anger always comes due to frustrations in life. Frustrations are normal with everyone. People learn to ignore frustrations when they get experienced. Do you get angry to circumstances outside your home as you get angry at your house? Your office, bus stand, railway station, neighbors etc. If yes, you might need to get evaluated for anger issues. If NO, just understand and compare the two situations and you can be better yourself.Psychotherapy techniques should suit your requirement. If you require more of my help in this aspect, Please post a direct question to me in this URL. Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques.Hope this answers your query. Available for further clarifications.Good luck. </s>

<s>[INST] Hi, may I answer your health queries right now ? Please type your query here. Hi am 34yrs 5ft 68kg.my result raed staflocucus,i was gvn 10 days AVECF INCTION WHC I KOMPLET LS SUN,ALSO DACIN-F 300MG.BUT AS I WAS TAKEN THE INJECTN I STARTED PURGEN ON D 7TH DAY.doc aftar stulen my annal(anus) itches me alot.wht do i do?thanks [/INST] Hello,Thank you for posting your query to HCM.From what you are describing it might be a thrush infection. It came after the use of an antibiotic (Dacin-F), and the anus is a place where fungal infections tent to grow.If I was your caring doctor, I would suggest to take Canesten 2% cream, to use twice/day for 5 days. If it is used with a thick layer, spread to cover about 2 cm over and outside the borders of the itchy place, it will be enough to clean the infection. Try to keep the area clean and dry. If it doesn't get better, or is getting worse, consider to have it checked by your local doctor. Its very low possibility to be something else, but sometimes is better to have a look.Let me know if you have any further question.Regards,Dr. Klarida Papaqako. </s>

<s>[INST] I am exceptionally healthy for a 60 yof . I am 5 3 , weigh 120 lbs, am very active, have no illnesses, have never experienced any type of joint pain; however, for approx. the past 3 months, I ve experienced a gradual progression of right shoulder pain when I move your arm up or backwards. The pain is deep and piercing to the lateral aspect of my shoulder. On a scale of 1-10, my pain is maybe a 7-8. Should I get a referral from my family Dr to see an Ortho? [/INST] hi,thank-you for providing the brief history of you.A thorough clinical orthopedic shoulder joint and cervical spine assessment is advised.Based on your symptoms of having pain in the lateral side of the arm there will be a possibility of either of the factor which can be ruled out by a special clinical test performed by an Orthopedic.The conditions leading to shoudler pain are - * PA shoudler* Bicepital tendonitis* cervical disc disease* Adhesive capsulitits* Bursitis etcon performing the orthopedic clinical special test a provisional diagnosis is made . May be you will be recommended for an X-ray or an MRI based on the requirements..post which, you will be advised to undergo physical therapy as it will help improve the strength in the muscles by exercises. As most cases recover sooner in my clinical experience based on the stages of recovery. But a 99% strength in the muscles can be achieved and pain can be relieved as well.regardsJay Indravadan Patel </s>

<s>[INST] hello i am 26 yers old female. i have a dental problem. before 2 months i found a crack in the bottom side of my front theeth, after some days there are chak like some thing out from that teeth and become a hole. and after 2 months i found that the same thing in another teeth . please tell me what is this problem i dont have any pain or bleeding in my teeth. how to recover from this problem [/INST] HelloI have gone through your query.it can be due to caries(cavity) in your teeth.plz mention your profession or any habit if u hv.chalky substance can be a sign of early caries or any defect in enamel.there is nt mch to worry bout.as there is no pain i suggest you to visit a dentist and get it filled.Hope this ans fulfills ur queryRegardsDr. Shesh </s>

<s>[INST] Hi Doctor, My Father is suffering from liver cancer, he is 64 years old , we are currently checked in CMC velllor(Tamilnadu ,Indai).Now Doctor said it comes under stage four liver cancer with Hepatitis B. Doctor said no need to take any treatment just live it as it is. Pls advise what should i do . he is normal now but little bit sick. [/INST] Hi,I am sorry but stage 4 of liver cancer is a highly advanced stage where the cancer has metastasised to various other organs and parts of body, on top of that viral infection with Hepatitis B has further complicated the things. Therapeutic approaches for the treatment of HCC can be classified into three categories: potentially curative, palliative, and symptomatic. Potentially curative treatments, including liver resection, transplantation, and local ablation, are associated with promising 5-year survival rates of up to 75%. But is not possible when carcionoma is in a very advanced stage. Due to the presence of excessive metastatic disease, the patient is not a candidate for curative surgical resection. Other forms of local therapy, such as percutaneous ethanol injection, cryosurgery, radio frequency ablation, hepatic intra-arterial chemotherapy, or chemoembolization that typically play a role in the palliative treatment of patients with localized, non-resectable disease, are not appropriate in this patient with metastatic disease. Cryosurgical procedure can be tried but are not very successful. Follow advice of the doctor at CMC Vellore.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ramesh Kumar </s>

<s>[INST] 3year olds feet ( most often just his left foot) falls asleep often. Doesn t seem painful but just annoying to him. Happening for about 5 months. Last night he said both of his feet weren t working right. He was standing at the time. Also he complained about left eye and mouth not working once. His eye was noticeably slanted down. He also has sensory processing disorder....mild and highly functioning and gifted. Tested at three and was gifted off the chart. What about feet?.. [/INST] HI BASED ON YOUR COMPLAINTS, I CAN INFER THAT YOUR CHILD IS HAVING A NEUROLOGICAL PROBLEM- POSTERIOR OR DORSAL COLUMN DISORDER ASSOCIATED WITH SENSORY DEFICIT. PLEASE CONSULT A PEDIATRIC NEUROLOGIST IMMEDIATELY TO FIND OUT THE CAUSE OF IT. HOPE IT ANSWERS YOUR QUERY </s>

<s>[INST] 18 year old male weight 176 lbs. Active, works out, and plays summer AAU basketball.Woke early morning 5:30 AM June 18, 2013, with enlarged and moderately painful upper abdomen.Doctor took blood sample and found liver enzymes elevated 6X normal.Next day ultra sound indicated no problems, but gall bladder wall slightly thicker.Wed June 26: Performed Upper endosocopy of stomach and upper small intestine -- biopsy did not find anything. Gastroenterologist said mild ulcers in stomach and lower esophagus found. Prescribed omeprosole for 6 months. Ordered colonoscopy for July 10.Blood work June 25 showed liver enzymes now back to normal.Played basketball on Thursday, June 27, and had mild headache.Played again on Friday morning, June 28, resting in late afternoon and asked me (dad) to look at his right eye because he thought something was in it. Right eye blood vessels very dilated -- so took him to ophthalmologist who prescribed Dextromycin-Dexameth Ophth susp drops.Saturday morning he woke up at 8:00 AM and vomited yellowish bile before breakfast and had a bad headache.Called on-call gastroenterologist and he said because of headache take him to emergency room.They drew more blood and said he did not have mono or dehydration -- throat started to get real sore and emergency room doctor prescribed hydrocodone and something else for nausea -- departed hospital.Took hydrocodone on limited basis unless pain was severe, only took nausea medicine on Sat afternoon.Slept from 4:00 Pm on Sat June 29 to 8:00 AM (16 hours) on Sunday, June 30.Sunday still had headaches and very sore throat. Monday, July 1, eye very good, but upper body covered in red rash.Took him to doctor -- doctor thought maybe allergy or unknown virus causing all symtoms.Tuesday, July 2, rash diminished. Wednesday morning, July 3, took to doctor due to continued headaches.Doctor thought might have bacterial sinus infection due to virus and doctor prescribed Amoxicillin. Took more blood to check for West Nile virus (negative). That afternoon headache started to get bad again, so gave hydrocodone -- hour later started giving the prescribed Amoxicillin.Did not have any headaches after taking medicine on Wednesday afternoon, July 3.During this 2 week time he lost 7 pounds.Colonoscopy on Wed, July 10. Doctor checked large intestine for Graves and other stuff, alsochecked lower small intestine. Did not find anything. Thought it could be Graves but would have to do more tests of small intestines. Decided to wait and thought maybe virus was cause of all the symptoms.Said to let him know if symtoms returned or anything happened. Son has only regained about 3 pounds.Thanks [/INST] Hi dearWelcome to the Board of Health care magicGone through your elaborated history and came to conclusion that you had a mild attack of hepatitis and along with that you also developed some gastritits.Hepatitis is usually self limiting disease. it subsided of its own with out causing much trouble to you. All the symptoms headache,pain in abdomen bloated abdomen can be explained with hepatitis.For the gastritis part you have already prescribed omperazole for 6 weeks which you should continue.Hope you should recover with due coarse of time with this treatment only.Thanks </s>

<s>[INST] I have a constant dull pain on the lower right side of my abdomen . When I lay down and press in firmly I do feel a small hard lump. My bowels often feel like they are strangled, some sort of stricture happens and I am unable to have a BM and my blood pressure goes up. What is going on? I have had four abdomenal surgeries in the past. [/INST] Hi, . Lower right quadrant abdominal pain are associated with a few medical condition. The most common one being appendicitis / appendicular mass. Other possibilities are mesentric lymphadenitis, inguinal hernia, muscular ache and so on. The abdominal pain and lump in right lower abdomen concerns me. Since you been exposed to 4 previous abdominal surgeries, there are chances that what you could have be related to those surgeries. A detailed abdominal examination, ultrasound examination and or CT/MRI scans of abdomen is warranted to confirm the diagnosis. I suggest you to report to your gastroenterologist. Hope this helps. Wish you good health. Regards </s>

<s>[INST] I have 36 years age, 5ft and 5 inches height and 75 kgs weight, Alt=180 and ast=70 . i checked from Lab its a pairs Hepatitis B and Ultra sound says that i have fatty liver, dr. said that you start injection, i am a poor man and i cant afford lot of money, kindly advise other way for treatment, [/INST] HelloThanks for asking query on HCM. You have HBsAg positive status and fatty liver on USG, AST of 70 and ALT of 180. This is insufficient data for me to opine on the treatment plan. The rise in AST and ALT may be due tohepatitis B or non-alcoholic fatty liver disease, treatment of which are entirely different or a combination of both the factors. I would suggest you to undergo - HBV DNA (quntitative) and E antigen testing. After this I would be able to opine on the treatment. If the said injection is peg interferon and if you dont want to take, there are other alternative tablets which are simple to take. But the recommendations can only be made after the blood reports.Take care </s>

<s>[INST] Hi Dr Bhushan, I have a history of multiple kidney stones in both kidneys since 1999. I now have some edema in both lower legs, and some large soft lumps in both my ankles. Does any all three of these symptoms suggest something else going on with my kidneys or can these symptoms be from the stones since there are so many? [/INST] where are the bumps on ankles?do you have any picture or x rays of it.are the painful ?has a stone analysis been done ever?what is your serum uric acid , calcium and phosphorus level ?yes, sometimes kidney stones and painful crystal deposits on joints can be part of same disease like gout and calcium pyrophosphate crystal induced arthropathies.also get your urine test and kidney functions if there is swelling on feet. </s>

<s>[INST] is oosure known to be great for treatment of pcos in order get pregnant. I am 27 year old female with PCOS on both ovaries. Cysts are not that big but they are becoming hurdle in getting pregnant. Any answer regarding this will be helpful to me to have a hope for getting normal pregnancy [/INST] Hello and welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. PCOS cause hormonal imbalance, ovarian dysfunction, menstrual irregularity and difficulty in conceiving. Along with this, following treatment will helpful to become pregnant:- Progesterone pill: It will be given in luteal phase. It make uterine environment favorable for implantation and support the pregnancy.- Metformin: decrease insulin resistance and mainatin glucose homeostasis.- Clomiphene citrate: It induces the ovualtion and should be taken from 3rd to 8th day. It increases the chance of pregnancy. It should be taken for 3-5 cycle. USG and ovarian follicle study should be done after taking it to know the ovarian follicle rupture. If follicle size will 18-21 mm then high chance of pregnancy. If ovarian follicle dose not rupture then HCG injection can be useful.So you can ask for above drugs to your gynecologist. Avoid stress, take small frequent meal rather than large meal, drink plenty of water, do regular exercise and maintain weight according to BMI.Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Sagar </s>

<s>[INST] About once every month or less I get a feeling of my heart flip flop. I do not get a fast heart beat. I was put on Altenolol for anxiety/panic attacks. When I get these flip flop then go into major panic attach. Had EKG/and echo, both normal, blood tests normal. Are flip flops normal? [/INST] Flip flops or palpitations are very common. If you have had the symptoms evaluated and found no underlying heart disease or dangerous rhythm, the primary concern is to relieve your symptoms and anxiety. You may want to discuss treating the anxiety with your doctor. There are several, non habit forming alternatives available from a family of drugs called the SSRI's. </s>

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

<s>[INST] hi my daughter had a lesion removed from her ear and they termed it PEM or overlaps with animal type melanoma she went back in and had a wider margih removed.my question is will she need any other treatment and if so what would she need? [/INST] The list of treatments mentioned in various sources for Animal-type melanoma includes the following list. Always seek professional medical advice about any treatment or change in treatment plans. Surgery along with radiotherapy Surgery Excision of primary +/- regional lymph nodes Excision of metastases Chemotherapy - mainly used for metastatic disease Biological therapies - for metastatic disease Radiotherapy - may be used for treatment of symptomatic bony metastases, or cerebral metastases </s>

<s>[INST] I have lower right abdomen pain when I urinate, and when I walk around. I recently had a UTI, and finished 7 days of antibiotics yesterday (trimethoprim). It is definitely pain in the abdomen and not in the urinary tract. What do you think this might be? [/INST] I think that the pain is due to cystitis which is a part of the urinary tract infection that you have mentioned. The urinary tract extends from the kidneys in the upper posterior abdomen, through the ureters, into the bladder and out through the urethra. What you are talking about is the urethra only. But the infection could extend into all these parts, especially the bladder, and could indeed be the source of your lower abdominal pain. I think that the abdominal pain during passage of urine is due to this infection. Since you have already completed the course of antibiotics, please drink plenty of water to flush down the infection and soon things should be back to normal. Still, it might be worthwhile to mention the symptoms to your treating physician and get his valuable opinion. </s>

<s>[INST] My 9 year child has developed puss in lower molar teeth...also his upper teeth is also infected. We have consulted 2 doctors one is saying that antibiotics can cure this...but the other is recommending root canal treatment as he is suggesting that since the puss is aggravating it will infect more teeth. Also the shape of the teeth is also effected...its blackening with cavities. Please advice which solution we should go for? [/INST] Hello,Thanks for writing to us.Since the tooth is infected associated with abscess formation,i would would suggest you to get root canal treatment done.Pus has to be drained and curetted.Medications can relieve pain/infection temporarily.Please do visit a dentist and get further treatment done.Take care. </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] Hi , i have renal problem from last 4-5 years n now my cretinine is 1.9 .. now its constant . need ur help cz now form last one also suffering from heel pain n back pain .. any suggestion for treatment ...yesterday .. i went to a doctor for this & he only suggested me for DOLO 650 tablet ... plz let me know for further treatment [/INST] Hi, it is always better to consult a nephrologist only for treatment of the heal pain and back pain. He will be much familior with the drugs which are friendly with the kidneies. I to my patient with such symptoms prescribe injection of vitamin B1,6, and 12, for 5 consecutive days and then when ever there is pain. and local application of the diclofenac sodium . Thank you. </s>

<s>[INST] Hello Mem I m Sumanta Frm odisha(state) 25 year and I m suffering frm back before 2yrs ..I think my spinal position is bend frm lower and dat is very painful .x-ray report shows there is a gap in disc L4 and L5..so plz mem recommend me some medicines or treatment for fill da gap and pain. [/INST] Hello samantha, gap what some body has told you is not a problem. All bones had a cushion in between which on x rays looks like a gap. What causing yproblem is disc herniation. It can be checked on mri only. Treatment is physiotherapy and drugs. Medicine like myospaz and myoril are helpful. </s>

<s>[INST] Hello doctor,I had a cesarean 4.5 years back, after which I developed a sinus tract in the left lower abdominal wall (which was stated to be tubercular (though there was no discharge). Took ATT twice but when repeated USG was conducted, it stated the problem as panniculitis. An MRI revealed adhesions and b/l sacroiliitis. Saaz 500 mg and Pregabalin was given, but not availed much relief. I had a history of bronchial asthma for the past eight years and somewhere I felt Saaz did not suit me and increases my asthma problem. What should I do? If I do not take Saaz it increases my back problem a lot and overall tiredness and if I take I feel breathless.Got a recent ultrasound done. Can you please check and see if TB is still persisting or is it panniculitis? Completely tired of this diagnostic dilemma. Please help. I will be grateful. I am attaching all my reports of the past five years. I have bronchial asthma since last eight years. Viral keratitis in right eye post eye lasik surgery. LSCS four years back. Herpes zoster right arm three years back. I have dry eyes for which I am taking Systane Ultra, Flomax ointment and sometimes Cycloiimune 0.5 drops. For asthma, Budamate inhaler and Alerfix total. Please guide. [/INST] Hi. I will try to help you as much as possible. A few questions first: 1. Was there any tissue biopsy done for the abdomen wall or the panniculitis lesion? If yes, please share its details. 2. Did you have symptoms of low backache and early morning stiffness, and pain in any other joints? 3. Did you have any family history of arthritis? 4. Do you take anti-inflammatory medicines in addition to Saaz for pain? Now coming to your queries: USG and MRI reports (attachment removed to protect patient identity) are suggestive of abdomen wall panniculitis, which is a chronic inflammatory condition and is mostly caused by some autoimmune process. In your case, the associated sacroiliitis may point towards the presence of spondyloarthropathy. Tuberculosis is unlikely, as it would have resolved after ATT. Bronchial asthma diagnosis needs to be worked up in order to rule out other autoimmune associations like ILD. I would like to suggest the following, if not already done: 1. HLA B27, RF, and anti-CCP. 2. ANA by immunofluorescence. 3. ENA profile. 4. ANCA (MPO and PR3 by ELISA). 5. ESR (WG) and CRP. 6. Pulmonary function tests, and X-ray chest. 7. Tissue biopsy from the abdomen and its histopathology examination. If you are finding it difficult to tolerate Saaz (Sulfasalazine), then, other drugs like Methotrexate (MTX) may be tried, but only after ruling out the possibility of ILD. MTX would also be helpful in panniculitis. for more severe pain, NSAIDs or low dose Corticosteroids may be added for short term. But it is important to establish a final definitive or most probable diagnosis. </s>

<s>[INST] I have what I believe is a muscle strain that has been painful for several weeks. The pain is in my upper left arm. I was doing some research online and would like to know whether I should be using ice or heat on it or both? Right now, I am using Aspercreme rubbed into the arm several times a day. I have also figured out how I can move my arm with the least amount of pain. [/INST] Hi, i am understanding your concern. I want to suggest you something as per your question, in muscle strain, immediate treatment includes Rest and ice. In first 2 days you should apply Ice (Not directly on skin) for 7-10 minutes along with rest. It helps the muscle fibers to heal and rest and After 2 days go for hot fermentation. It will enhance your healing and increase blood supply to your injured fibers. Wish you good health. </s>

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

<s>[INST] Hi My son is having tingling nerve endings in his upper body, on his back and front; also in his feet slightly. He is 28 years old and very fit generally. He is afraid that it could be a sign of neuropathological disorder. He is a physiotherapst, Any advice would ne welcome. regards, ann [/INST] I would start with a MRI of the cervical spine, and an examination with a neurologist to see if further bloodwork, EMG testing could be useful. </s>

<s>[INST] Hi my 6 month old is just getting over viral bronchiolitis but he is sweating quite a lot and his temp is 35.5. He had no temp during his virus. He's eating ok, plenty of wet nappies but does seem a little more fractious than normal. Is his temp ok? Thanks Victoria Callaghan [/INST] Acute bronhiolitis is most commonly caused by respiratory syncytial virus (RSV, also known as human pneumovirus). Other viruses which may cause this illness include metapneumovirus, influenza, parainfluenza, coronavirus, adenovirus, and rhinovirus. His temperature is low , give to him to drink hot water </s>

<s>[INST] I fall down on one side of my face one week ago, and I have some dizzy spells since, only in certain position, like I shift side when I sleep, or bend over. also, I have this strange pain on my left side chest area, when I cough, it cause sharp pains, I have to hold the area before cough. Should I be concerned? [/INST] Thanks for your question on Health Care Magic. I can understand your situation and problem. Yes, you should definitely consult doctor for your symptoms. Dizziness and fall down is something related to brain. So you should consult neurologist and get done clinical examination of Central nervous system (CNS) and MRI brain to rule out internal damage. Also get done blood pressure monitoring because high blood pressure can cause similar symptoms. Chest pain on coughing is seen in lung infection. So get done chest x ray to rule out this. So consult doctor and discuss all these. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. </s>

<s>[INST] Hi there,I am 29 and recently had the latest treatment the Six months Smile or 6 months braces treatment. My orthodontist said it might be 6-9 months for the treatment. I have a gap with my front teeth and slight over crowding with my bottom teeth. When I was about 14-15 years old, my dentist suggested I remove my lower wisdom teeth that were apparently causing the overcrowding. Because I was scared, we only managed to remove my right bottom wisdom tooth.Since the removal and now reading through online articles, I am more and more concern about facial disfiguration. I have the impression that since the right bottom wisdom was removed that my profiles left and right are different.Will the braces fixing the gap and overcrowding (even though I am NOT removing more teeth) likely to cause more disfiguration?Please let me know your thoughts. [/INST] Please rest asurred your profiles of left and right side will not be different.Braces fixing is done for cosmetic reasons and take long time to show its result Adhere to the advise of your orthodontics and forget worries Dr Lal </s>

<s>[INST] I have a, what seems to be, rash in the crease of my legs next to vaginal area and it seems to be spreading towards the lips. It is extremely pinkish red, itchy, burning, and skin keeps peeling away from it causing it to start bleeding. This has been going on for 4-5 months now and I don t know what to do it just keeps getting worse. [/INST] Hi, It can be a fungal infection like jock itch. You can apply anti-fungal ointments like Clotrimazole for symptomatic relief. Nothing much to worry and in case of persistent symptoms, you can consult a dermatologist and get evaluated. Hope I have answered your query. Let me know if I can assist you further. </s>