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<s>[INST] Hello doctor, Our newborn baby suffered in first inhalation and his heartbeat stopped one second and then his breath and heartbeat got restored. But x-ray shows some traces (please refer attachement). His heart is normal and he is in ICU for normal treatment of oxygen and normal feeding through external pipe. Kindly explain the x-ray. Will feeding with external pipe create any problem to the baby (he is just one day old)? [/INST] Hello. I have gone through the reports (attachment removed to protect patient identity). Consult a paediatrician online for further follow up --> </s>

<s>[INST] It is not really painful. just a little discomfort. My back tooth bothers me a little and I constantly have a sore in the roof of the mouth . The sore is next to the bad tooth. It feels like a pimple and has a point or a head. [/INST] hi, you did not tell that this is the last tooth or another tooth........... anyways discomfort and soreness is because of infection/caries in that tooth.............. and if it is a wisdom tooth it may be bacause of infection in that area............ so please go to your dentist and get the whole mouth examination done.......... after examination follow all the instructions given and go for a proper treatment.... nothing to get worried......... take care Dr.Gunjan Gupta </s>

<s>[INST] upper left quadrant abdominal pain.....right below the bottom rib.....very specific area every time ....... intermittently over past month. No other symptoms........is intermittent but today is radiating into upper left back. Otherwise healthy 50 yr old. Exercise, eat right, no health problems. Did have multiple rib fractures on left side 5 yrs ago due to horse accident. No constipation, diarrhea, vomiting or fever. [/INST] Hello, Thanks for your query.This looks like a positional anomaly. The upper back ache is a result of muscle spasm which in itself is a protective mechanism body develops so that the back avoids abnormal posture. For pain to go, it takes not only rest (on a comfortable bed) but also avoidance of particular positions (during work, rest or recreation).If the back pain is unbearable take medications/ pain killers or muscle relaxants prescribed by your physician. And if it has been long standing illness visit your orthopaedician and clinically-radiologically establish a diagnosis to commence definitive treatment.I do hope that you have found something helpful and I will be glad to answer any further query.Take care </s>

<s>[INST] Hi i am having pain in the joint of my big toe, on the top where the toe meets the rest of the foot in that big joint. Its painful on top of the toe and it hurts to walk and i am walking to lose weight. What can i do to make this stop as I can start out walking and its fine but then something feels like it pops and then it hurts like heck and is hard to bend the toe to walk. Help [/INST] Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. As per your history, it may be due to gout or overuse during walking. iKindly do complete haemogram, CRP, ESR and uric acid after consultation with orthopedician. You may require x ray of affected joint after consultation.Take care. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shyam B. Kale </s>

<s>[INST] hi doctor, my wife is having high fever (104.8 ..sometimes) ...it starts with shivering & body pain...it is happening since last three days ..started on sunday .shivering with fever starts after 6-8 hrs gap...her ultrasound report(abdomen,pelvic ) is normal, MP & Widal tests are also negative ...please suggest ..wht all symptoms i should look for .... ? [/INST] Hello ,I understand your concern. I am Dr. Arun Tank, infectious disease specialist, answering your concern.You have not tested for dengue for your wife. Dengue can also cause same symptoms. I advice you should take the dengue rapid test done under your doctors guidance. Once we have proper diagnosis we can start treatment accordingly.Till that time I advice you to take paracetamol for fever. Once you take the drug the fever will disappear.Please drink the water as much as your wife can drink. Fluid balance is very important in this case. Or you can say fluid therapy is the only cure for the dengue.I will be happy to answer your further concern you can contact me here or you can contact me on bit.ly/DrArunWe wish you a best health at healthcare magic. You can hit thank you button if you are helped.Thank you,Dr. Arun Tank </s>

<s>[INST] Hi, I get tightening of my lower back if I am on my feet for couple of hours. Also sometimes get bextreme burning sensation in a small area ( say around 4-5 square inch ) with a particular point in the middle where it is extreme as if a needle is being poked. Please advise [/INST] Hello,i had gone through the case and found that these symptoms might be due to pressing of nerve between lumbar and sacral region.So go for lumbar vertebrae X-ray and Vitamin D3 and Calcium level in blood. After getting the correct diagnosis take treatment. meanwhile do the exercise for sciatica under medical supervision.Hope my answer will be effective for you.Thanks </s>

<s>[INST] Hello doctor, I took an HIV CMIA test on 26th day after a sexual encounter. The test result is negative. I had protected sex but I saw some blood on the inner parts of my partner. And also at the time I was having two pimples on my penis at the end and not on the tip. I am concern about that. Is an HIV test on 26th day conclusive? [/INST] Hi. HIV negative test report at 26th day post-exposure is quite assuring, but, a confirmatory HIV antibody test is further required at three months of last exposure. There are no specific symptoms by which we can diagnose HIV. The complaints which you are having could be due to multiple reasons and do not necessarily means HIV. For the complaints you mentioned besides getting tests for other STIs (sexually transmitted infections) like HBsAg (hepatitis b virus antigen), anti HCV (hepatitis C virus), VDRL (venereal disease research laboratory), gonorrhea PCR (polymerase chain reaction), herpes simplex 1 and 2, I also suggest you to get vitamin D3 and vitamin B12 levels. Is there any fever as well? If so, please send the temperature record. Please revert with the reports. </s>

<s>[INST] I was taking gutaka for last three years. Now I have the problem in mouth. I cannot open mouth fully. My mouth became whitish. What is the problem? Dentist says the first stage of cancer. Is it true. Now what can I do to prevent from occuring cancer. Help me [/INST] Please immediately quit gutka (tobacco) use.You need to have a biopsy of the whitish patch to rule out cancer (malignancy).Please discuss it with your doctor. </s>

<s>[INST] my mother was recently diagnosed with Pancreatic cancer. She is 69 years old and has dementia. In the past year I have had red grease floating in the toilet when I go to the bathroom. I occassionally have really bad stomach cramping and diarreah (sp?), maybe once or twice a month. I have had sore back for years...I am just worried that I may have something going on with my pancreas. I had a physical a couple months ago and all of my blood work came back normal. The physical was before my mom's diagnosis though and I am wondering if I should be concerned in light of what is happening with my mom... [/INST] Thanks for your question on Health Care Magic. I can understand your concern. In my opinion, you should not worry much about pancreatic cancer. You should get done annual health check up with ultrasound examination of abdomen and tumour markers to rule out early pancreatic malignancy. Your present symptoms are mostly suggestive of irritable bowel syndrome (IBS). Stress and anxiety are the most common causes for this. You might be having too much stress, anxiety due to your mother's situation, which is causing you all these. So avoid stress and tension. Be relax and calm. Get done annual health check up. Don't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks. </s>

<s>[INST] Hello doctor,I am 21 years old and I have always been a shy person. When I was younger I used to sweat a lot because of it and I could barely speak with anyone. As I got older, I became more and more sociable, now I have got friends, I am getting along with everyone at work and I am feeling quite good about myself. I have never been depressed and I am a really happy person. The problem that I am facing is that whenever I talk to somebody, with anyone at all, my heart starts to rush and my face becomes red in just one second. I blush like I have done some dumb thing and it is intense and very very red, anyone can notice it. I have tried to manage it by going out as much as possible and I have learned that when I get comfortable with someone, the blush and red face thing disappears (but it took two years to get comfortable with my boss for example). I am aware the problem might be associated with anxiety, but I have never taken pills for it. I just want the blushing to go away, as that will make me less awkward and better in general. I have got a mitral valve prolapse and a ventricular hypertrophy. [/INST] Hello. The problems you have mentioned like the history of shyness, palpitations and flushing of the face on talking with any new person, etc., are occurring most likely due to anxiety. This could be due to social anxiety. You are facing these problems in day to day routine too and to get rid of these symptoms you should consult a psychiatrist for help. Drugs like SSRI (selective serotonin reuptake inhibitor) can help you to come out of the anxiety. Sertraline can be tried. The drug is safe even for cardiac problems. Behavior therapy and relaxation exercises can also be tried to come out of the anxiety. Please visit a psychiatrist for help. For more information consult a psychiatrist online --> </s>

<s>[INST] my granddaughter has had a fever of 105, a rash,irritable, will not eat or drink.. the Doctors said it was an ear infection, an anitbiotic was given, 12 hours after taken the antibiotic she has a swollen gland on one side. still is ugly, will not eat or sleep- this is not her natural nature- I am concerned for her health- she is only 11 months old- do you have any advist/questions that need/should be asked at the visit? [/INST] hi,sorry to hear about your grand daughter,high fever with rash and irritability needs proper evaluation like blood and urine tests.antibiotics alone is not enough,pain relievers,adequate fluids and rest and proper diet is needed.i would suggest yopu to take her to a pediatrician and evaluate her properly.have a good day </s>

<s>[INST] My brother started a publishing house, and had lots of hopes for its success. Unfortunately he failed in his business. He is highly qualified and writes very good and sensible blogs. The problem is he keeps thinking that one of us, the family members have done something to contribute to his failure. He blames all of us for his failure, so much so that he has gone away leaving his family, even his wife and kids. his old mother as well as sister. He writes blogs and occasionally publishes a book. He is isolated, has no contact with us. I wonder if he has a psychological problem. Please help me understand my brother s behavior. [/INST] Hello,The information of your brother is reflective of delusional disorder. In his case he has suspicion over his family for ruining his business. Such illness initially affects family life and relations of the patient and it is not possible to convience them for treatment. Usually, lately the health, self care and work is also affected. There can be add-on depression or anxiety above the delusional disorder.The only way to treat such patient is by giving them medicines regularly. They should be brought back to family home and meds are given hidden in food or forcefully or by regular conviencing them. With drugs there is significant improvement in their behavior and anger and blaming attitude. Within few days there is good improvement in most of the cases but drugs should be continued for a long time (6-12 months atleast ) else the effect weans off.wish you good luck.Dr. Manisha GopalMD Neuropsychiatry </s>

<s>[INST] Hello doctor, I have recently had an MRI and ultrasound scan for acute cholecystitis and they showed multiple cysts and a 16 cm x 12 cm cyst in my liver. Please could you tell me is that large for a cyst as I have been told it needs further surveillance. It is showing two benign looking hepatic cysts. [/INST] Hello. A 16 cm cyst is a bit large cyst. A few more details about your condition would be quite informative. Have you ever had any pain in the abdomen or jaundice in the past? Any contact with sheep, any pet dog? Kindly inform what was the management for acute cholecystitis, was cholecystectomy done or just managed with antibiotics and other medicines? If it is possible to upload the images or reports of the ultrasound and MRI, it would be really helpful to give a comprehensive opinion. </s>

<s>[INST] I have lower back pain. Have had multiple back opeations in the last 2 years. Last appointment with back doctor, the xray shows I may have another bone spur in my lower back. Could this pain that I having go down into my hip. I seem to have a lot of pain in my right hip. [/INST] HelloWelcome here.The pain in back radiates to hip. It might also radiate to thigh and leg.Bony spur might need a surgical intervention. But i would advise you to visit a physiotherapist first. Learn some back strengthening exercises. Take care of your posture. Do hot compresses and use a back-supporting belt if required. Avoud bending from your back.Hope this helps. </s>

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

<s>[INST] My mom is 87 has moderate dementia and has been given 5mg of Namenda twice daily. Now they have increased to 20mg. She has is now experiencing the following since increase: itching, stupor, vomiting, confusion,x back pain seeing, hearing things that are not there, anxiety, indigestion.....her quality of life has gone down hill within a week of taking increased dosage. I am thinking of taking her off this med because she is not the same Mom. Is it worth sticking it out or giving her some peace as she knows it? [/INST] Greetings !Well if a drug is causing more dis-benefits than the benefits it is expected to deliver then you shall bring the drug off and the same strategy is applied to Namenda ( memantine hcl) ad anyways namenda is an add on assisting drug for dementia while Aricept ( generic name -- donepezil ) is the chief drug that is used in dementia cases, so you may use that instead and bring her off memantine aka namendaI hope this helps.Regards </s>

<s>[INST] Hello doctor, i am 23years old and had anal sex for the 1st time with my guy and since we didn't know how yo go about it so it was painful and lead a bit of tear in the condom. We were a bit scared as to what if sperm reached vaginal area. We did it 2 days after my periods ended (monday). So i took unwanted 72 within 2hours. Now after 7 days (sunday) i got bleeding. It's light as of now. But i might go to doctor for checkup. So will the doctor get to know if i had taken pill by any test she does for this irregular period? And can i be free of worry with respect to pregnancy? Kindly help. [/INST] Hello, If you have done anal sex only then there is no chance of getting pregnant, and there was no need of taking medication as well and it can’t be revealed if you have taken any medication unless and until you wouldn’t tell your doctor. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Naira Jahangir, OB and GYN Specialist </s>

<s>[INST] I am 25 and have had asthma as long as I can remember, consequently my allergies tend to make me more senstivie to asthma. Now, while it's usually well controlled, I feel that the last few weeks I have been wheazy and short of breath more than I can ever remember. Is there any reason for this as nothing in my life has changed. (Physical exercise, diet, rest, etc) [/INST] Thanks for your question on Healthcare Magic. I can understand your concern. By your history and description, possibility of acute exacerbation of asthma is more. Wheezing, shortness of breath are classical symptoms of acute exacerbation of asthma. You might be having some viral or bacterial infection which is causing this acute worsening. So better to consult pulmonologist and get done clinical examination of respiratory system, chest x ray and PFT (pulmonary function test). Chest x ray is needed to rule out lung infection. PFT is must to know the severity of asthma and treatment is based on severity only. So you might need antibiotic and additional inhaled treatment. So consult pulmonologist 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] My Name is Abdur rehman.I have done my semen test recently.Quantity:8.5,color:greyish white,total count:98millions/ml,active35%,sluggish:20%,non motile:45%,pus cells:8-10/HPS [/INST] Thanks for the query Your semen analysis is alright but for a few pus cells. Take Tab ciplox 500 twice a day for 1 week. Repeat the semen test after a month. If the question is will u be able to conceive a child then yes your semen is good enough for conception Have a healthy living </s>

<s>[INST] I have had a sore cheek now for over a week and my dentures hurt when i put them in my upper right is ok but my left one is very sore I have been swishing my mouth for a few days with salt and warm water and I am leaving for a two week vacation and I hope this is going to be ok while I am gone to the Bahamas? [/INST] Hello, Welcome Thanks for consulting HCM, I have gone through your query, as you have mentioned that you have that you are wearing denture, go to dentist you should go for triming of denture may be sharp edges causing you pain sore cheek Do warm saline gargle two - three times a day Apply ointment Mucopain twice daily Hope this will help you. Wishing you good health. </s>

<s>[INST] I had cellulitis in my right hand. After both IV and oral antibiotics I still have thumb, index and middle finger that are not working. I can bend them but they tingle, throb, thumb also burns a bit. Nerve damage? Can it be fixed if it is? [/INST] Hello,You need to see a hand surgeon. It sounds like you may have some median nerve entrapment. A steroid injection may help relieve this. If not surgery may be necessary.Regards </s>

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

<s>[INST] Hi doctor,I am a boy, 18 years old. My right knee has clicking sound without any pain. Please help me out of this. Is this symptom of any big disease? Tell me some things to cure this. [/INST] Hello. You have what sounds like Chondromalacia patella which in itself is not a major problem and commonly seen in young adults who are still growing. You will need to do a regular exercise of the knee and stretches of the hamstrings and most problems resolve once you stop growing. No need to get tensed up. For more information consult an orthopaedician and traumatologist online --> </s>

<s>[INST] Last week I did ultrasound and blood test. There was no heart beat of the baby from ultrasound and my HCG level initially it was 35000 then after 2 days it dropped to 31000. Now I am 9 weeks, still today the ultrasound result is the same. My doctors told me to do D&C but I really stressed [/INST] HiFall in HCG level with no heart beat is cosistent with finding of non viable pregnancy. As the repeat USg shows the same result, D and C is the right treatment </s>

<s>[INST] Please keep my name anonymous. I m wanting advise on if I maybe pregnant. I ovulated may 9th. My husband and I had sex may 8th and 9th. I was suppose to get my period may 22nd. It never came until May 28th. (I am never late) But it was not my normal. It was light at first with bright pink blood and later on that day is had a little brown to it. But late that night and next morning it was heavy with clots and started cramping. I ve took 3 test (may 24th, may26th, and may29th) and all said not pregnant. When I got pregnant with my first I had a period in the beginning and had took several test and all said no also. It was like 6 1/2 7wk pregnant I finally got a positive. With my second I never got a period back from breastfeeding and was going to go in for surgery that morning and just to make sure I took one and I was pregnant about 5 1/2 weeks. I was wondering if you think I am pregnant and had late implantation bleeding or am having a miscarriage. [/INST] Hi, it can be a implantation bleeding als8o. You can confirm by doing a urine pregnancy test after 1 week. You can also go for a ultrasound to clear the doubt. If everything is normal, then it is confirmed that you are not pregnant. Hope I have answered your question. Regards Dr khushboo </s>

<s>[INST] Hi, I have went to the doctor a about 2 weeks ago and he gave me antibiotics (clorom), i had swollen tonsils and a cough.. but now i having coughing fits at night and its worse than before, also finding it hard to catch my breath from all the coughing.. I have exams at this time so i really need to be able to get a good nights sleep. However, i do not have swollen tonsils anymore. This may have nothing to do with it but the week after finishing my antibiotics, I noticed I got some sort of hives all on my arms, no where else, they would appear and then disappear. They were not that visible, it was sometimes like I was scratching just my skin and no hives. I went to the doctor there a 2 days ago and she said there may be a possibility that I have a mild form of asthma and she gave me an inhaler, only to use when I have a coughing fit. I found it to be ineffective. [/INST] you must have post nasal drip causing tonsil problems if we give antibiotics in allergies cough increases take montair fx bd combintion of montelucast and fexofenadine syp ascoril 1.2 trsf bdsyp tossex 1 tsf night combination of cpm and codeine syp gelusil 2 tsf tds take 2 wk it will be perfectly ok but get it dignosed if recurs aain </s>

<s>[INST] Hi, may I answer your health queries right now ? Please type your query here... My four year old daughter started school in September, and I have noticed the children frequently sit cross-legged on the cold classroom floor. Can this cause, as my grandmother used to tell me when I was little, an infertility? [/INST] Hi, Sitting cross legs is a starting position in yoga, and most Indian people do it. It is not associated with infertility. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Cajetan, Pediatrician </s>

<s>[INST] I would like to know about kidney disease. My doctor has been treating me for bladder infections this past year. He sent me to a bladder specialist who sent me back to my primary care doctor. Now I am waiting to talk to a recommended specialist on the kidneys. The one he recommended cannot see me till the end of Oct.. My primary wants me to be seen within this week. I am dizzy, one leg swells up more than the other. I have high potassium and my creatin levels have been high. So has my B D. Many times it is high or a good number on top but the lower number has been in the 40's, 50's. Last night my hand was ice col and numb. My legs have also been numb up to my calfs. I didn't want to go back to bed because it scared me. I don't know whether to alarm my primary and call him or not. [/INST] 1. your symptoms of high potassium-B.P-hyperkalemia, creatine, points towards CRF but numbness and edema in one leg: one has to rule out DVT by color Doppler.2. avoid high protein diet.3. take carbohydrates and fat as usual.4. avoid potassium ( banana, papaya, cheese,tomato, potato, grapes, coconut water, fruit juices)5. take calcium </s>

<s>[INST] I had my eyebrows, Upper lip and chin threaded to remove facial hair. Now I have raised, red, fluid filled bumps that look like pimples, but they are itchy. I washed with cool water, tried hydrocortisone ointment, Took benadryl and even tried aloe Vera. Nothing is helping. Please help. [/INST] Hi,I can understand your concern for raised, red, fluid filled bumps caused due to threading eyebrows, upper lip and chin. I can make a possibility of Allergic dermatitis due to threading.In Allergic dermatitis there are eruptions along with moderate itching and in more aggravated cases there is appearance of more redness which persist for more than mutiple of days.The only precaution you must follow is not to touch, pinch pop or squeeze any of them other wise it can get infected and can cause complications. If I were your treating then would have prescribed a medium potency steroid cream application such as mometasone or fluticasone cream. You can take antihistamine benadryl or loratadine by mouth.Take care. </s>

<s>[INST] My name is subidha.Im trying to get pregnant.Im 22 years old. My periods are regular. I have some problem with my ovulation.My doctr said me...I dnt have any ovulation,then she gave me tablets .Now, for 3 months onwards, Im eating this tablets and ovulation is going good. everything is perfect now.But, im not getting pregnant.We checked my husband semen analysis. He dont have any problem. [/INST] Hi, Thanks for the query.I understand your concern. With you acheiving normal ovulation & your husband having normal spermcounts ..there is no basic problem in conception.Try with - having sex around your ovulation (determined by ovulation test .-L H Surge test.at home/usg scanning - Do have hormonal support with your treating doctot's advise. - Pregnancy test( blood test giving earliest results.. done inlaboratory / home regnancy test after 8 days delay in mendes ) used for early diagnosis & treatment plan followejd strkitly with doctlor's adivise. - Both of you shoulf start taking folic acid & vitamine E suppliments . You should succeed lwithin 6 months. If not go for detailed investigayionslike tube testing. Thanks </s>

<s>[INST] I had a severe abscess on an upper molar which reached my eye socket and caused lump in roof of mouth. Was on antibiotics for 3 weeks during which time the tooth was removed. That was back in mid April. Although I have no pain, the lump is back on the roof of my mouth which when pressed causes blood and fluid to come out where the extraction was done. My ear also feels blocked [/INST] Hello, Read your query, as you have swelling at roof of the mouth after removal of tooth this can be due to still infection is present at site of tooth removal this can be due to formation of supurative osteitis or this abscess can be due to carious tooth present in same upper arch. Do warm saline gargle two - three times a day, Do betadine mouth rinse. Consult dentist and go for investigations IOPA Xray if there is infection then go for treatment . Hope it help you If you have further query , I will be happy to help. Regards, Dr. Priyanka tiwari </s>

<s>[INST] Hi I am a 30 year old female who has an open bite which I am very self conscious when speaking to people and smiling is there any solution to this? as it's only my 2 front teeth which doesn't overlap with the bottom teeth. I am thinking of extracting my four front teeth and have partial dentures so that I can have a perfect is that advisable? [/INST] Hi! Welcome to Healthcaremagic.I read your query. Open bite can be due to jaw relation disturbance or occlusion disturbance.Extracting front four teeth wont provide a solution for this. You need to visit an orthodontist, who will study your jaws and teeth, take few x-rays and then decide the treatment.Usually teeth allignment is done using braces for 9-12 months varying from case to case. Extraction of one or more premolar may be required for making space. Then fixed braces will be attached to teeth exerting required force to move teeth in desired allignment.Now a days composite braces are available, which are esthetically better.Hope the answer helps you. Thank you! </s>

<s>[INST] Hi, may I answer your health queries right now ? Please type your query here...HI this is Krishna I have a Chest pain when i am walking continously for 10 minuates and at the same time i have pain in Left rest . I am scaring this is somehting related with Heart Attack. I have taken X ray and ECG.Doctor said Both are looks fine. Can u please suggest me how to proceed.regards Krishna [/INST] Hi, If you have symptoms and ECG is ok, I will suggest that you should undergo TMT treadmill testing, stress echocardiography. The final thing is angiography by conventional invasive way or by CT angiography or MRI angiography. You should also undergo blood pressure monitoring, lipid profile and blood sugar. Avoid sugar, salt, fatty foods. If all come normal, then relax. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Varinder Joshi, General & Family Physician </s>

<s>[INST] My husband is experiencing extreme back pain. He has been lying down, but when he tried to get up a little while ago, he almost passed out. He went white, so I made him lie back down. He started to sweat and became nauseous. Is this normal? What should I do? Do these symptoms warrant a trip to the ER? [/INST] he should be taken to ER.sudden fall of Blood pressure and nausea may be due to some other reasons and careful evaluation is essential. </s>

<s>[INST] My mom has multiple myloma. Platelet counts keeps dropping. Doc is giving procrit injections to boost blood cell, but nothing additional for platelets. Anything out there effective for boosting platelets? She s currently getting 2 chemo injections per week & takes steriods Mondays thru Thursdays.Has taken revlamid in the past to boost counts & it worked, but side effects were bad bad bad. Doc discontinued revlamid becuase of that, but may start again (lower dose) soon because her counts are so low. [/INST] thrombopoeitin injection might help in boosting platelets but a number of injections is needed for this to take effect </s>

<s>[INST] I have severe pain while pooping during my period, but no other time. I am not sure why. I also have really heavy periods and bad cramps. 18 years old. [/INST] I also have this problem. You described me perfectly. I'm 23 and have always had this happen. Sometimes I truly hate being a girl. Lol! </s>

<s>[INST] I am 40y male with hypertension and I have had back pain for the past week. Last week I was throwing a football and over extended my throw. It caused some brief pain in my right back by the scapula and spine. Later that night I was sitting on the couch leaning forward and started to feel an intense sharp pain in my right chest. I sat up straight and it went away. It did happen a second time that night from leaning forward. The next couple of days I felt like I had a knot in my back and some tightness. Eventually this led to me waking up with the right side of my back swollen and having random shooting pains in my back and chest. It got to the point where I was in so much discomfort that I went to the ER. The hospital did verify that it is not a cardiac issue. I am out of the hospital now and was told to take ibuprofen and rest up. Which is what I am doing. I am just concerned about my symptoms. I generally feel very run down with feelings of having a hot face, a little diarrhea (maybe from the pain meds at ER?) and elevated blood pressure. Is it normal for back pain to cause symptoms like this? [/INST] Hi there, it sounds like the doctors at the hospital thought this might be costochondritis or perhaps muscle strain/ spasm given the recommendation for ibuprofen and rest. If no CT scan or MRI was done of your Thoracic spine, that would be the next step if your complaints of shooting pain don't get better (especially if they wrap around your chest to the front) to make sure there is not a bulged disc there that is causing your symptoms. Back pain specifically is not known to cause elevated blood pressure, but pain certainly can do this. </s>

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

<s>[INST] Hello doctor, I am concerned about a bone lump on my right foot in the tarsal area, probably talus, or calcaneus. I am not really sure. It is located on the right side of my right foot below the ankle joint. I am attaching pictures of me pointing at the spot. There is a small ganglion near it but I am not concerned about that. The bone lump is what that is troubling me. There is no pain at all almost. It is there mainly when I drive and use the gas pedal a lot. I know about it for more than half a year, but it was there probably longer. It is smooth when I press on it and kind of round and hard as a bone. I have had some x-rays done on my feet, it was some time ago but the lump was there back then. My biggest concern is that this could be some kind of bone cancer. I am also sending the x-ray files of both of my feet. Could you have a look at them? [/INST] Hello. I have gone through the attachments (attachment removed to protect patient identity) I understand that you are concerned about a lump in your right midfoot on the outer side. The probable cause is a benign bony prominence. However, differential diagnoses include a calcified ganglion, accessory ossicle, a subluxed peroneal tendon, ankle ligament sprain, and tarsal coalition. You described the lump as a hard lump with a smooth surface. The pictures you sent suggest that it is around 2 cm long and 1cm wide. Investigations that need to be done include anteroposterior and lateral and oblique radiographs of the right foot. The fact that it has been there for a long time and that there is no pain is reassuring and goes against cancer. However, it is important to know if there have been any recent changes. Prevention measures include wide comfortable shoes with good padding. The attached files only contain clinical photographs.There are no radiographs to comment on. Kindly upload the reports. You need to contact a doctor if the lump changes or becomes painful. For more information consult an orthopaedician and traumatologist online --> </s>

<s>[INST] Age 45, female According to Widal test, Serum (slide Agglunation), Salmonella typhi O : Reactive 1:40 (1:80 & above significant @ to test) Salmonella typhi H : Reactive 1:40 (1.16 * above ) Paratyphi AH & BH are Non Reactive [/INST] Dear Friend.Widal is a non specific test and carries low sensitivity for Typhoid.Since , we can have subclinical infections due to consumption of outside food , so , Widal test can be high in normal person too.So , what is important is rising titres of Widal. If titres are rising , means you have typhoid.So, decision to treat would be based on your clinical features and symptoms.Discuss with your doctor.Get Well Soon. </s>

<s>[INST] I am 20 year old, 5 4 and roughly 10 and a half stone. A couple of months ago a pulled a plug out of the socket and gave myself quite a bit shock. My arm hurt quite a lot at the time, but now it still aches, all the way from my shoulder down to my hand. [/INST] Hi first get checked if the shock has caused any damage to bones. Get an x ray for that. If your x ray is fine then its due to muscke soarness for which you can use musclr relaxant like zerodol MR 2 times a day for 5-7 days. </s>

<s>[INST] I have several sicknesses at the same time. I recently started taking Sertraline (generic for Zoloft - 150 miligrams) and Busporine (5 miligrams) for anxiety. I also for many years have had very bad seasonal allergies for which I took quite a bit of allergy medicine during those times. I now have a cold and allergies at the same time. What medicines can I take to treat this while on the other anxiety medicines? I don t want to mix the wrong stuff. Any help would be appreciated. [/INST] HI, thanks for using healthcare magicThere is a potential interaction with buspirone and setraline. They both increase the levels of a chemical called serotonin.High levels of serotonin can potentially cause serious problems.Setraline can potentially increase the level of loratidine (claritine) but does not interact with the other antihistamines or decongestants that you may use.I hope this helps </s>

<s>[INST] Hi there, I just have general question about bruises. I have a dent on the side of my leg near the hip and one on my calf That developed after bruises sustained from horse kicks. I have two friends that have dents from similar situations. Is this something that will affect mobility later in life? Are there any steps to reverse this? Thanks [/INST] Hello, A dent on the side of the leg can be due to a fascia in the muscle mass that will not affect the mobility. This can be a physiological variation also. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Praveen Tayal, Orthopaedic Surgeon </s>

<s>[INST] Hi Doc, this is James here. I have a medical query. Help me... my query - My sister 20 years old is a patient of SLE for last 8 years. She is on steriod therapy for last 6 years. Now she had problem of pain in stomach and vomiting, 4 times in a month. We went to our Family Doc, he suggested us for Sonography. And he found a 10 mm stone inside Gall Bladder. Can you guide us what will be the next best step should we go for surgery if yes educate me about the surgery... [/INST] Hi Welcome to HCm Read your prob,SLE is autoimmune multisystem disorder. it affacts heart brain blood n other organ of body, so first you rule out disorder in heart lungs n liver if you find every thing is normal n Hb ,platlets are normal then you do surgury for gall bladder stone other wise avoid it. </s>

<s>[INST] Hi, I got off a plane two days ago after drinking a lot before the flight. I heard lots of popping and my right ear was in pain on the flight. Since I hav got off my right ear has been numb. I also suffer from anxiety and have a Cole sore on my lip which has been there for like 3 weeks and left untreated. Any ideas wot this could be.? [/INST] DearWe understand your concernsI went through your details. I suggest you not to worry much. I don't think anxiety and cold sores are in anyway related. Popping in your right ear could be due to the pressure difference in the plane. If you want to address your anxiety issue separately, please consult a psychologist as soon as possible.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] Hello doctor, My son is 13 years old and he has bleeding nose problem. Kindly advice. [/INST] Hello. Bleeding at this age should be evaluated thoroughly there may be a lot of possibilities like a JNA (juvenile nasopharyngeal angiofibromas), NPC ( nasopharyngeal carcinoma), nasal polyps hematological causes, etc. So an urgent diagnostic nasal endoscopy with a complete blood count should be done if there is persistent on and off bleeding (profuse) from the nostril. Also, take the history of any trauma to the nose. </s>

<s>[INST] i was playing basketball and jumped up to get the ball. however, someone tackled me and i fell flat on my back onto the ground. after the fall, i got abdominal pain and my head was aching. as i proceeded to the shower, i noticed that there was blood when i was spitting out a deep spit or coughing. i am not sure what i should do. [/INST] Hello,By history you have sustained an injury to the back and the head by falling on your back.Headache indicates that there is some impact to the head.Abdominal pain may due to spine injury or involvement of hollow organs of the abdomen.Blood in the spit is a very serious concern.It may be due to injury to the base of the skill.Consult a neurosurgeon. </s>

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

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

<s>[INST] Hello doctor, I am 30 years old male. My recent blood report shows high ESR level (48 mm/hr). I am having a cough, fever, and a headache since eight days. The doctor told me that I have a viral infection, and has given me antibiotics and a cough syrup. Please guide. [/INST] Hi. Consult your physician, with keeping all this in mind. Revert with more information to a general practitioner online --> </s>

<s>[INST] Yes I just experienced an acute episode of fluttering in the base of my throat, a rapid dropping feeling in my chest, SOB, although my respirations are 18/min, light headedness, while I was driving on the freeway, checked my blood pressure/heart rate when I arrived home, bp was 110/60, heart rate was 156, the feeling of being SOB, tachycardia persists, I m a hospice nurse & deal with pts with various cardiac issues but normally end stage, I have experienced this before but not this extent. It s very alarming almost a fearful feeling, joy sure if it could be a panic attack or maybe atrial flutter. What would you recommend? [/INST] Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. I would explain that your symptoms could be related to possible cardiac arrhythmia. For this reason, I would recommend consulting with your attending physician for a physical exam and some tests: -a resting ECG and cardiac ultrasound -thyroid hormone levels for thyroid gland dysfunction -blood electrolytes for possible imbalances -an ambulatory 24-48 hours ECG monitoring for possible cardiac arrhythmia. Hope I have answered your query. Let me know if I can assist you further. </s>

<s>[INST] Im a male. A small, dime size lump appears sometimes at my perenium. If i squeeze it hard, a pussy, bloody mixture excretes. I went to urgent care 3 months ago and the nurse practitioner called it follicititus, gave me antibiotics and suggested to go to emergency room if it comes back. It came back. What is this?? [/INST] Hello,As per my clinical experience, lump on perineum with pus discharge can be a boil, sebaceous cyst or else with infection.If not resolving after recurrent course of antibiotic, an option of minor surgery can be discussed out with your surgeon.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Bhagyesh V. Patel </s>

<s>[INST] sometimes i have really fast heart beats in a normal condition and sometimes strong constriction, having difficulty to breath. Also it have started losing my breath, in sense that i get tired soon and i need fresh air and really deep breath to come in normal condition [/INST] hello thereyou have not mentioned your age however your symptoms appear to be that of extreme anxiety...Please consult a psychologist and try deep breathing exerciseshope that helps </s>

<s>[INST] I have this bump on the hairline in the back of my head near my neck.It itches extremely.At first it was a bump and I kept messing with it and it popped and puss and blood came out it.the area is now red and itches constently. What could it be and how can I get it to stop itching? [/INST] HI.This is either a sebaceous cyst or a skin disorder.. It is better to get this removed (excised) for 2 reasons.1> your get rid of the disease and 2> you get the histopathological diagnosis- makes you tension- You have to undergo a proper clinical examination to be done by a Doctor who can catch many of the problems on your proper history and physical examination and can then guide for further investigations and treatment.Get an opinion of a Doctor / Dermatologist preferably. </s>

<s>[INST] Hi doctor. Just want to ask. My penis started to itch and present allergy like symptom almost 2 weeks ago. It became puffy. The left part of my lip(mouth) felt tingly. After 3 days, my penis started to have black spots. One is a big circle and there were lesions on the glans and foreskin. It turned from itchy to painful. My left lip also had a small crack that s why it is also painful. Please help. [/INST] Hello,,Itchy penis and black spots on foreskin makes me suspect that probably you are having candidal posthitis which is more common in diabetics, whereas recurrent bacterial infections are also common if one's blood sugar levels is raised.I would suggest that you take a course of an oral antibiotic (penicillin or cephalosporin group e.g Amoxycillin or cefadroxil for a week) to take care of the bacterial infection.An OTC antifungal cream e.g clotrimazole cream, can be applied twice daily on the cracked foreskin. An oral antifungal e.g fluconazole 150mg single dose would also take care of the candidal posthitis.THank you. </s>

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

<s>[INST] Hello doctor, I have been on a rollercoaster, and I found a tiny lymphnode on the left side above the collar bone. So I went to my ENT, put a scope down my nose, he said to keep an eye on it, it has not grown since I found it. I got an ultrasound today, and I guess it is smaller than what I thought, its 3x3 mm. What do you think? [/INST] Hello. The lymphnode you are talking about is insignificant. You need not worry about it unless it grows in size or become painful. Some lymphnodes grow bigger in size due to hyper reaction, so you need not worry. </s>

<s>[INST] HI I had my implanon inserted on 12/2012. Ever since then I was doing fine with just light spotting here and there. And I noticed that I would have no spot or anything for 2 months and then I would have a little spotting and a light spotting and so I am currently started spotting like 2 months aready. well it feels like it. and just a couple days ago I started cramping and bleeding heavier than usual. and clotting kind of bigger than usual [/INST] Hai, Thanks for using Health care magic.Irregular bleeding after contraceptive implants are common side effects.It ranges from No menstural bleeding, spotting, light bleeding & at times heavy bleeding too.But these are common in the first one year of its insertion.If heavy bleeding is prolonged & recurrent clinical examination & evalaution by your Gynaecologist is advisable. Dr.Vasuki </s>

<s>[INST] I get dizzy spells all the time...numbness in my face and finger tips....I have had a chronic neck problem and perhaps a pinched nerve....currently I feel no neck plain...so do you think my neck is the reason for my dizzy spells or could it be something else? [/INST] Hello, As due to pinched nerve there will be tingling, numbers etc for the upper limb and fingers. Which can be taken care of by MRI neck, soft collar, neck stabilization exercises, upper limb strengthening exercises and inter-scapular muscle strengthening exercises. But the symptoms on the face like numbness needs a cranial nerve examination and may have involvement of the higher motor functions. Post a diagnosis for the higher motor function we can guide for the medical treatment. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist </s>

<s>[INST] Trying to figure out if my 18 year old daughter has an underlying health issue. She has been spiking fevers and has been sick 4 times in the last 5 months. Twice in the month of February. As recent as last week after taking a swimming test to be a lifeguard (which she passed). So we ve noticed that it may be after exertion. At first we thought maybe because she was at college, exposed to a lot of bugs, but has happened now since she s been home too. Symptoms: fever, body aches, general sinus stuff, cough. [/INST] Hi, Without an exam, I can only give general information, but it's pretty good in this case. Fever implies inflammation. this can be from a generalized condition like an auto immune response or an infection which is generally pretty localized to one area and has symptoms that focus On That Area such as cough and sinus stuff. Chronic sinus/lung/ or infection anywhere along the respiratory pathway can give fever and might need just antibiotics or with chronic conditions often/usually has something bent out of shape like an abscess or stopped up sinus that needs (usually really minor) surgical correction. Looking for something bent out of shape, looking for a collection of pus would be the firs step and then antibiotics if small and surgery then antibiotics if big. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Matt Wachsman, Addiction Medicine Specialist </s>

<s>[INST] yesterday I had hardened skin over muscles where the backbone ends (gluteus maximus muscles I guess) in my buttocks. No pain, not really itchy. For the previous 1-2 days I ate a lot of pastries with wallnuts and sugar in it. I also have some kind of arthristis in my joints (a rheumatologist from Istanbul is trying to diagnose at the moment - she says it may be spondillitis). Back to my hardened skin, I took a claritine (10 mg) last night and it looks like it is almost totally gone. Why did that happen? It was first time in my life. [/INST] Hi Hope this message finds you in good health.Such kind of hardened skin occurs due to paraspinal muscle spasm.Due to inflammation,the skeletal muscles under the skin go into spasm and become stiff.This occurs if you have underlying lumbar spondylitis.Get a MRI of the back bone done to diagnose.Taking muscle relaxant tablets will help.Hope your query has been answeredGet back to me for any doubts that you may have.Kind Regards </s>

<s>[INST] I have two leaky heart valves and mild cardiomegaly, along with Fibromyalgia and Chronic fatigue. I did have Sleep Apenia, but I lost some weight. So I am told I no longer have the sleep problem. My cardiologist tells me my heart issues are not that serious and I should not worry and to just lose a little more weight and keep my BP under control ( I am on med for that). My question is the fact that I remain constantly tired and sleepy, so much to the point I can barely work my full time job. I can t even bathe myself at times. I have no energy to do basic stuff like my house work and I am afraid to drive for falling asleep. I have Asthma as well, but none of the treatments for the Asthma is working or has ever worked for me. To make matters worse I have problems breathing all the time, and constant pain in my chest on the left side, fluttering from time to time, stomach bloated. My cardiologist insist that it is not my heart that is causing these problems. When I go to places like Walmart I can no longer walk around the store I must ride one of the scooters. He insist it is the Fibromyalgia causing these problems or the Asthma. Yet the ashtma medication does not healp. He also think it maybe the Acid reflex, so I see a Castro fir that. I don t want to wait until things get worse and then I find out later that maybe my heart problems were more serious than he or I thought and not treated earlier on. I had a aunt that had heart problems and it was not treated in a timely manner and she passed away. Also have a good friend that has the same problems and her first doctor failed to treat her problems and her second doctor jumped right on it, right away and was so upset that her problem was not addressed earlier. She has since had surgery and many complications as a result of not having her problem treated early on. Although she is 10 years older than I. I will turn 58 this Saturday. I just want to feel better, I have no life outside of work. I go to work and barley make it through the day and come home and try to sleep or just sit and read and write and watch TV. I have attempted to excercise, but my energy level will not allow it. I am now weighing 171, I have lost 10 lbs. I even had my tonsils and uvala removed to health with the breathing. It did not help much. I do not go anywhere, because I am just to tired and not feeling well. I attempt to rest to get my strenght back to return to work on Monday. Today is Monday and I am still not feeling well enough to go to work. I am giving a lot of thought to changing my cardiologist. First he told me my heart was not enlarged and then he told me it was. Then he told me I didn t have any blockage and when I continued to complain about the chest discomfort , he admitted I did have a slight blockage (20%) and it was not that bad.Thanks for your time. [/INST] Hello, As you explain the history you have already done everything you can. Try just to do the treatment. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Jnikolla, Pulmonologist </s>

<s>[INST] I have a relative you was rushed to the hospital with severe chest pain and was diagnosed with Upper GI spasm.... He was discharged today after being in hospital overnight, but still having considerable pain which comes and goes. How long will the pain last? thank you [/INST] Thanks for your question on Healthcare Magic.I can understand your concern. Most common cause for upper GI spasm is GERD (gastroesophageal reflux disease).So better to follow these steps for faster relief infection GERD and spasm.1. Avoid stress and tension, be relax and calm.2. Avoid hot and spicy food. Avoid junk food.3. Avoid large meals, instead take frequent small meals.4. Take pantoprazole and levosulperide combination on empty stomach twice daily.5. Quit smoking and alcohol if he has these habits.6. Go for walking after meals.7. Keep 2-3 pillows under head in bed.Don't worry, he will be alright in 1 month with all these.Hope I have solved your query. I will be happy to help you further. Wishing good health to your relative. Thanks. </s>

<s>[INST] I noticed a mosquito like bite on my testicles on my right side, since I thought It was just a mosquito bite I left it alone, since the itching persisted, I cant handle it anymore. Just today I took a shower and I noticed that I have an identical bite on my left side my testicles , almost simetrical. I don t know if this is a concern or anything. [/INST] HelloThanks for query.What you suspect to be mosquito bite are likely to be small sebaceous cysts over scrotal sac,The scrotal skin is rich in sebaceous glands and hence prone to get more sebaceous cyst due to accumulation of sebum beneath the skin.Normally they fade away without treatment however they need to be treated if increase in size or get infected.Please consult qualified General Surgeon for clinical evaluation and further treatment.Ensure to observe proper personal hygiene.Dr.Patil. </s>

<s>[INST] The right side of my neck has been feeling weird. I have myself convinced there is a small moveable lump, but I have also been obsessing over feeling my throat for a couple months now. I have had a lot of stress and anxiety but now I m stressing even more that it s something serious. My mood has been slightly down recently and I also have no appetite. [/INST] Welcome to healthcare magicI am Dr Fahim and I will help you with your problem      I have gone through your question and understood your concerns. It appears to be cervical lymphadenopathy, mostly commonly caused by upper respiratory tract infection as you mentioned that you are having a bad throat. Viral is more common than bacterial. Bacterial which is usually staphylococcus and streptococcus, needs antibiotics like Co-amoxiclav, while in viral infection the lymphadenopathy is mostly self limiting, requiring no treatment apart from analgesic like paracetamol for symptomatic relief.I hope my answer will help you. Do rate it, if you like it.Regards </s>

<s>[INST] hi. iam 23 years old . i am married for 3 years, with no protected sex. me and my husband has done all important lab tests and every thing is totally normal there is nothing wrong. i had 1 IUI and 1 time took all imjections and tried the normal way and nothing success. my last period was march 22/2010 after 10 days from missing period i did the home pregnency test it was negative( on that day i was on stress and very angry) i didnt do it in the early morning it was during the day . now my period is 2 months late , i feel some times nausea , dizziness. head ach i kept for whole week feeling head ach but not any more a little of back pain not severe. iam becoming over weight a little bit. i didnt repeat the home test.am not having any bleeding or spots. or any excessive secretions every thing seems to be normal. but some times i get some contractions in my abdomin 1 week ago it was a little severe the duration was for 24 hours and then it was over. i am feeling lost i dont know what to do. plz help [/INST] All of ur complaints are related to stress and anxiety.Nothing is wrong in getting pregnant.Just try to regularise ur periods through diet and regular excercise.Do Ultrasound pelvis to rule out PCOD.Try to reduce ur weight.IF u have PCOD tak9e treatment for that. </s>

<s>[INST] I am 22 years old and for 7 years now I have been struggling with lower abdomen pains. The way I usually explain it is that my ovaries are trying to rip themselves out of my body. I have been to multiple doctors and I have heard everything from growing pains to cervical cancer, and it is none of the above. Most of the time it is just a discomfort, but when its bad I get physically sick, the pain shoots down my cervix, into my legs and behind. My periods, if I'm not on birth control, will last for months and be a heavy flow the whole time. Medications don't help, if anything just make me sick. Nothing helps. I have done some research of my own and came to the conclusion that it is endometriosis, but every doctor brushes it off. I'm at a loss of what to do. I hate being in so much pain, and being tired all the time. When it gets bad, I can't even get out of bed. So I generally will camp out in the bathroom in case I have to throw up. Where do I go from here if I can't get a doctor to listen to me? [/INST] Hi.Thanks for your query and an elucidate history.I can understand the plight a young woman of 22 years is going through for the last 7 years in spite of the continued consultation with Doctors. After reading your history I would advise you the following:Take a Second opinion of a very senior Gynecologist and a General Surgeon in combination so that they can examine you in person, get detailed history, advise you investigations and then come to a particular conclusion in consultation with each other.I would advise you the following:Blood-Hormonal studiesUrine and stool tests;Ct scan of the abdomen. Most important Hysteroscopy and Diagnostic Laparascopy and procedure as may be warranted. This approach only can help you get a proper diagnosis and treatment . Evaluation by a Psychiatrist certainly helps in many such patients with similar problems that you have . </s>

<s>[INST] I am 20 years of age and for the past month and a half I have felt very tired, not a lot of energy, low sex drive, and at times light headed and nautious. Could these be signs of low testosterone?? I am 6 foot 2 inches tall and weigh 160 lbs. thank you [/INST] DearWe understand your concernsI went through your details. You are just 20 and you should not think about low testosterone level. The given conditions could be due to many other problems including stress and obsession. In your case, I am suspecting your stress and obsession. Think about it. Were you stressed? in the near past? Do you think and obsess too much about sex and related problems?You may consult a sexologist and get your testosterone checked. But don't worry about it.If you require more of my help in this aspect, please use this URL. Make sure that you include every minute detail possible. Hope this answers your query. Further clarifications are welcome.Good luck. Take care. </s>

<s>[INST] hello Doc . I stayed in a hostel last sat night and on sunday afternoon. I noticed that there few red dots show up on my face . I thought it was spots at the beginning but on Wednesday it s all over my face like a rash . It is not painful or itchy to start with. I went to boots and the pharmacist suggested me to take Piriton Allergy Tablets . Now my face start to itch after taking them for 2 days. I don t know if I should carry on taking them ? Any one might know what caused it? I am a bit worried now because i m getting married in 2 weeks !!! please help. Thanks you !! [/INST] hAI, iT MAY JUST BE A SIGN OF A PIMPLE. Also look for allergy to shaving creams and after shave lotions. Just apply an antibiotic creams like clindamycin, if it is due to pimples you will be alright before your marriage. Drink water not less than 3 liters and include plenty of fruits, vegetables and greens and avoid foods prepared with butter, ghee and dalda or vanaspathy. Get well soon Dr S M </s>

<s>[INST] I have been having chest pains on and off for two years. I get a sever tighness in my chest just above my heart. After doing many tests they found that I have an accending thoracic arotic anurysm. I have gone to the hospital serval times since. My symtoms are always the same. I get a heavy sever pain in the same area. moving doesn t change it. After a few moments I feel like someone has tied something around my chest and is cutting off the circulation to the left side of my chest, left shoulder and left arm. It then travels up the left side of my neck and feels like a large hand has spread out over the left side of my head and face and is tring to pop it. Then my left temple begins to have a sudden pain, pulse for a split second the fade away for a few moments. My anuerysm is a 4.1 and I have been told that it will have no symtems. Today I have had 7 nitro pills and the pain will ease up then come back again strong. History has shown that it will pass and I will be wesk for a few days and find it hard to stay awake. I am tird of going to the hospital I feel like they think Im crazy. What should I do? [/INST] Thanks for your question on Healthcare Magic. I can understand your concern. In my opinion, your all symptoms are due to ascending aorta aneurysm. Aortic aneurysm can cause Coronary artery disease (CAD) especially when it is ascending aortic aneurysm. So in my opinion, you should definitely consult cardiologist and get done fresh ecg, 2d echo, stress test (trade mill test) and coronary angiography to rule out CAD).Strict control or blood pressure is also needed. Salt restrictions, fat free diet are also beneficial in your case. Don't worry, you will be alright. But first rule out CAD.Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. </s>

<s>[INST] My son plays football and recently he was running the football and a linebacker hit his right shoulder with his helmet. He has been having issues raising his arm, in front of him and across his body. It has gotten a little better with anti inflammatory and pain meds but now it s stalled out on the healing. [/INST] dear sir/ madam since your son has a history of injury, most likely he has injured his rotator cuff,i wouldlike to examine him for any local tenderness, give rest to his arm ,give a arm sling pouch, ice pack , for a week, and then after a week do some manuevers to test rotator cuff,and then start physiothearpy to the shoulder </s>

<s>[INST] I have a question about stopping testosterone replacement therapy after 10 weeks 200mg a week of cypionate, my last shot was 2 weeks ago. Can I stop and if I do will I experience anxiety or depression at all?I have nolvadex handy from a friend and was debating taking that. [/INST] HiThanks for using healthcare magicPsychotic symptoms, excessive libido and aggression, in addition to physical and psychological dependence and withdrawal syndromes have been rarely described with testosterone treatment, though the validity of testosterone or the cause is uncertain. Few studies have mentioned that no significant changes in behavior, function, depression, or cognitive performance occurred following 12 weeks of testosterone replacement in men with low testosterone levels and early-to-moderate cognitive impairment. So, there is no need to worry.Thanks </s>

<s>[INST] I fell and hit my shin on the sidewalk in an awkward position, and it swelled up like a baseball. Five days later there is still a large (much smaller though) lump which is rather pointy and red. It is still hot, though not terribly painful. I believe I hit the vein. Will it heal alone and is there anythign I should do? thank you...I am 43, 5'6", 140 lbs, and otherwise fairly healthy. [/INST] Hello!Thank you for the query.Injury is a factor of veins thrombosis. And your symptoms indicate superficial veins thrombosis. If treated property it is not dangerous, however if left alone can lead to deep veins thrombosis.That is why I suggest you to consult a surgeon. Dopplers ultrasound should be done. If veins thrombosis will be confirmed you need heparine treatment.Hope this will help.Regards. </s>

<s>[INST] i have on and off headaches occurring irregularly. I often suffer from stiff neck, 2 months is the minimum difference of its occurrence. I always yawn. I have rhinusitis. I also suffer from pains in my back, it is like burning pain. I feel so low and always ffeeling fatigue. I am always irritated and hot headed. I rarely concentrate, and my memory is very poor. What is wrong with me? [/INST] A back muscle strain or ligament strain is one of the most common causes of acute lower back pain. Lifting a heavy object, twisting, or a sudden movement can cause muscles or ligaments stretch or develop microscopic tears.Correct posture is a simple but very important way to keep the many intricate structures in the back and spine healthy .Back strains often heal on their own with the help of some combination or rest, ice and/or heat application, anti-inflammatory medications, and/or gradual and gentle stretching and back bending exercises without jerks . walk , Deep breathing also helps for long time recovery .Bending forward is prohbited in back pain lower or upper back .For long term relief , take care to eat healthy balanced diet including more of fiber,protiens ,vitamins , minerals ,salt, less of carbs , fried , fasts foods Take raw ginger garlic and lot of water , A level Tspoon of turmeric powder with acup of hot milk in B/F and with almond oil 1 tspoon at bed time . Lemon juice in the morning with a pinch of salt and long pepper. This regimenwill fulfill your requirement of essencial nutrients Bowels should be cleared regularly . Hope this helps solve your query . Take care All The best Dont hesitate to get back if have any further query </s>

<s>[INST] is letrozole 25 mg good for me .i want to get preg fast? 29 yrs,pcod,irregular periods three month course of duluote-L then letrozole25mg for 5 days 1 tbl daily. no pregnancy is found .question is wether i stay with letrozole having double dose or again continue three month course of duluote-L ? as i had started letrozole this month could this tbl work for me if i start this medicine again. I want preg fast [/INST] Hello. Thanks for writing to us. If the pregnancy does not happen then the periods do come on their regular expected time. Lutrozole does not cause any delay in the periods. Recommended dose of lutrozole is 2mg. Taking a higher dose not increase your chances of conception rather it can be dangerous for your health. I hope this information has been both informative and helpful for you. Regards, Dr. Rakhi Tayal drtayalrakhi@gmail.com </s>

<s>[INST] Hello, i just went to the hospital as my family and girlfriend were concered for my pain in my left flank and the barley noticeable blood in my urine. ive had this problem for about a year now, a ct scan was done and the results look normal with no inflammation or free fluid in the abdomen or pelvis. Then a urine test showed with traces of ketones and a small amount of blood and mucus 1+ then with the blood test there glucose at a 6.1 and a CO2 at 32 both messured at mmol/L they belive that its not kidney stones. Which i was hoping it was only scared for the worst. [/INST] Hi ! From your history, I still feel that perhaps you have got very minute calculi in your kidney which is causing minimal amount of bleeding by friction against the kidney tissue. Such minute calculi may not be visualized in any of the scans. The pain may be due to the calculi blocking the ureter which possibly was passed out subsequently in the urine for which it was not visualised in the scan. I would suggest you to keep yourself well hydrated by taking of plenty of liquids which will also help flushing out any of residual calculi.Wishing you an early recovery. </s>

<s>[INST] Four months ago I had a spinal fusion on L3,L4 & L5. Although the most severe pain down my right leg has gone I seem to be left with varying symptoms that I would like to control without pain killers. Lifting anything like shopping from the car or bending to vacuum seems to trigger an ache in my lower back about the syatic area. This rapidly turns into weakness and I have to sit down to relieve it. Also walking any distance leads to weakness in my legs and they start to shake. I also have a general fatigue a lot of the time .. some days I need to go back to bed because I can t stay awake. I am walking about 500mtrs to and from work three times a week and feel this is building up my leg and back mussels again. I am also having a remedial massage once a week to loosen any knots. Most days my back becomes weaker towards the end of the day and I can t stand for more than a few minutes at a time. Sometimes I get a heaviness in my legs. It feels like they weight a ton and I m dragging myself around with not a lot of messages from my brain getting through. Nothing is consistent enough for me to put a finger on it so it is difficult to decide what works to relieve it. I still use 50mg quick release Tramadol when I ve had enough of the bite and I find once they start working I usually can get on with my day except for lifting or bending. Can you suggest anything. [/INST] the surgery done is not to relieve your pain but to prevent further instability and weakness. so avoid the work which is causing you pain n weakness. if so you can take simple analgesics like dolo650mg. do physiothearpy. </s>

<s>[INST] I HAVE SEVERE NEUROPATHIC PAIN THOUGHOUT MY T SPINE WHICH IS CONTROLLED AS LONG AS I TAKE KADIAN AND GABAPENTIN AND AM CAREFILL NOT TO OVERDO,INS CO. IS NOT WANTING TO PAY FOR KADIAN , WHAT CHEAPER MEDS IS SIMILAR ? I CANT TAKE NSAIDS DUE TO AB. BLEEDS, AND NOT TOO MUCH TYLENOL DUE TO LIVER DAMAGE ? [/INST] Tylenol (like water, and nearly all other medicines) is toxic only if a lot is taken at one time. The effect on the liver requires a certain amt. at one time or there isn't any damage at all and it doesn't accumulate over time.Kadian is morphine extended release and the generic of it is cheaper. </s>

<s>[INST] Hi, My name is Peggy. I have been having severe pain in my right foot just below my big toe and around my ankle. One minute I am in no pain then all of a sudden it feels like someone stabbed me with an ice pick and just as fast as it comes on it goes away, only to happen again a little while later. Could this be gout and what can I do to help the pain which is really bad. [/INST] Hello Peggy. Thank you for writing us here. The symptoms point towards acute gout but need not to worry. You just need simple analgesics for this. You can take paracetamol twice a day for 5 days and you'll be all fine. Also make sure you drink plenty of water so if the uric acid in your body is increased, it would be excreted. God bless youBest regards,Dr Gunjan </s>

<s>[INST] Hello doctor! I am A Female, 23 years old. My hair is usually covered most of the time and I am suffering from severe hair loss. I am totally healthy and I dont complain of any diseases or allergies. I am on a healthy diet. Will Neurobion coated tablets or ampoules help in hair growth? [/INST] Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. You seem to suffer from telogen effluvium. Consult the dermatologist and get perfect treatment. There may some cause. Stress,anaemia,vitamin deficiency,thyroid dysfunction or any internal disease may be the cause. Tab.Biotin 10 mg thrice a day and vitamin E cap 400 mg a day for long time might improve the condition. Multivitamin,iron and mineral may be taken if needed. Avoid stress and anxiety. Get treatment of any disease if you have. Hope I have answered your query. Let me know if I can assist you further. </s>

<s>[INST] hi i had taken valparin chrono tablets (300 mg in morning & 500 mg at night) for 4 yrs ...for the treatment of neurocysticercosis..now as adviced by doctor i hv stopped the medicine...but sometimes I feel unconscious after waking up in the morning...pls suggest if there is any side effect of these doses.. YYYY@YYYY [/INST] Hello, It produces neurological side effects like nystagmus, ataxia, etc. It also produces fulminant hepatitis, curling of hair. Some git disturbances also there. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr S.T. BALAMURALI, General & Family Physician </s>

<s>[INST] Hi, may I answer your health queries right now ? Please type your query here...Hi Dr.My girl friend has a hair fall suddenly of a one rupee coin size, she noticed it 2 weeks back, I got to know only today. Can you please let me know what exactly it is and how to cure this. [/INST] Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. According to your complaints it seems to be alopecia areata. I would recommend you apply topic steroid like Mometasone lotion on the affected areas twice daily. Hope I have answered your query. Let me know if I can assist you further. </s>

<s>[INST] I'm a copd patient, these are my medications: Ipratropium Bromide 0.5mg and albuterol sulfate 3.0mg, Qvar 80mcg both of these are used twice a day, Prednisone Tab 10mg once a day, Acyclovir Tab 400mg once a day for a herpes virus on my hip,Synthroid Tab 0.112mg, Omeprazole Cap 20mg, and finally Citalopram TAb 20mg Should I be dead by now [/INST] HelloI think the treatment is correct however it depends on the grade of your COPDRegardsDr.Jolanda </s>

<s>[INST] Hi doctor,I am 25 years old，male，had PSVT and did an RFA surgery two months back，caught a VT during Holter recently，UCG clear，MRI says left ventricular septum thickening about 20 percent. The local doctor thinks it is a viral myocardity，another doctor that I know says he saw of QRS and he thinks might be ARVC，what is your suggestion? I have high BP sometimes，and now taking Bisoplor and coenzyme q10. [/INST] Hello. Firstly, the possibility of ARVC (arrhythmogenic right ventricular cardiomyopathy) is less. MRI or echo would pick changes in the right ventricle. I guess right ventricle is normal on echo and MRI so unlikely to be ARVC. Next thing, you mentioned about thickening of the septum in MRI. What is about your echo finding, does it suggest anything pointing towards hypertrophic cardiomyopathy? So we should rule out hypertrophic cardiomyopathy. If possible, please upload your echo, MRI and routine ECG for interpretation. Regarding the possibility of viral myocarditis, it would show some changes on echo or MRI so that is also a less likely possibility if echo and MRI not showing any consistent changes. Also, troponin would be positive in active myocarditis. So I would once like to go through your detailed report and see if we can get some clue regarding diagnosis or else we will have to treat it like idiopathic VT (ventricular tachycardia). For more information consult a cardiologist online --> </s>

<s>[INST] i am a male 48yrs iwas hospitalise sometime last year complaining of dizziness and head ache later i was having spasm i was being treated with calsium intrav inj. and some high BP drugs, i later visited cairo where i did lots of test including endoscopy becouse of pain in the chest the results was that i am having lower end congestion etc and another test on my neck of which the result says certain bone is touching my code etc now i use to have like pain across my chest front and back when it comes my sight will blurr and my head will be heavy with slight head ache and dizziness [/INST] Hello, According to history, you provide your concern is related to the damage on the spinal (cervical) cord. You can take painkillers to relieve it. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Jnikolla, Pulmonologist </s>

<s>[INST] , may I answer your health queries right now ? Please type your query here... I've been having a soar throat where it feels like I have a peice of bone stuck on the one side of my throat. I cough,and when I cough I have a grayish green phlegm. I also notice that during the mid day it goes away,at night it starts to come back and when i wake up in the morning it hurts the most. I looked at the back of my throat in the mirror and it looks like i do have swelling of some sort one one side of the back near the tonsil. Any ideas? [/INST] HelloAs you explain the history you should be examined by an ENT specialist for evaluating the throat and the larynx better with a laryngoscope.ReagrdsDr.Jolanda </s>

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

<s>[INST] Hi had hernia operation 5 weeks ago was masterbating a few days ago and blood came out of my penis while masterbating got scared and waited till I need to go to the toilet but no blood just urine left it a few days and was just masterbating and blood started to come out again [/INST] Hi, Kindly consult the urologist. It is likely that the mild injury would have occurred in urethra while surgery. Take ethamsylate tablet after consulting your doctor to control the bleeding from urethra.Ok...Dr.Ilyas Patel MD </s>

<s>[INST] I had my wisdom teeth removed 17 days ago and I just noticed a small hole located on the bottom left side of my mouth where one of the teeth was removed. I was just wondering if I should be concerned about the hole. I am not suffering from any pain, but I would just like to learn exactly what it is I am dealing with. [/INST] Hi,Thanks for asking the query,The spot could at the place of the healed socket.If you are not having any pain then there is no chance of infection.But still a thorough checkup is required.I would suggest you to visit to a Dentist and get the checkup done.Take care! </s>

<s>[INST] Respected Sir,Here we need your valuable suggestion. Our patient is from Allahabad(UP). The patient Mr. Anmol, 18 years of age is suffering from severe pain. According to the doctors of our locality, this is the case of cyst in kidney and no treatment is needed. But the patient is suffering from extreme pain. Our question is 'Is the ayurvedic treatment is possible for this problem?'.Thanking you! [/INST] HelloYour patient findings suggest simple cyst in right kidney.Simple renal cysts are generally age related developmental findings and it only require follow up ultrasound.Renal cysts may require treatment if there is pain,increase in size of cysts,infection etc.Ayurvedic treatment is generally not helpful in such finding.Pain may be due to some other reasons.Your patient may need proper clinical evaluation and further investigations.Besides routine investigations he may need CT scan of abdomen.Treatment depend upon findings.Get well soon.Take CareDr.Indu Bhushan </s>

<s>[INST] I have been having severe pain in my right upper abdominal region. Normal CT. Normal Ultrasound. Vida reported 100 EF. Normal endoscopy (report just stated site of the stomach and duodenum). Could the EF be the issue? I have got to have some relief. [/INST] Hi.Thanks for your query.The causes of upper abdominal pain in spite of normal CT scan and normal Ultrasonography Normal Endoscopy can be :Dysfunction of the Sphincter of Oddi.Internal herniationHernia in the upper abdominal wall and so on. When the reports are normal - a careful clinical evaluation, actual physical evaluation by a General Surgeon can be really helpful as all the diseases are not found on any of the tests, which a trained hand can find. Vida 10 EF may not be related to the upper GI Abdomen. </s>

<s>[INST] Hello, I have a large lump in between my rib cage that seems to be similar to the xiphoid process. It has been causing pain for many years around my rib cage all the way to my back and has been getting progressively worse. Now that I have lost weight I can see the bulge in between my rib cage. [/INST] Thanks for asking your question here in this forum....Lum in the rib cage may arise from the skin,soft tissues or bone...its very important to know this...your history about duration ,mobility and fixity of the lump is important...but its important to tell you that the weight loss is not a good symptom...i will advise you to go to a surgeon and he will examin it and will give you the proper diagnosis...hope this will help you....thanksDr ihsan </s>

<s>[INST] I got my wisdom teeth removed a couple of days ago and I noticed this sticky almost plaque-like film over all of my teeth in the back and some towards the middle. I've brushed my teeth multiple times (as best as I can without hitting the stitches), as well as rinsed them with a salt water mixture, but the film hasn't gone away. Is this normal? [/INST] Hello and Welcome to ‘Ask A Doctor’ service.I have reviewed your query and here is my advice.Plaque like accumulation over the teeth can be due to tartar deposit that is at times calcified causing inability to remove with just brushing. So my suggestion is to consult your Dentist and get examined. If it is calculus deposit then it can be removed with professionally cleaning of teeth. You can however wait for a few days and let the wisdom teeth extraction site heals. Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Honey Arora </s>

<s>[INST] My mother is 78 years old. She was suffering from TB for past 6 months. She couldn t take AKT4 tablet. She got very serious last week and doctors advised to take home. Now she is normal. Taking regular food (little), urine and toilet are normal. The only problem is swelling feet. what would be the cause for swelling feet and whether this is serious one? What is the remedy? [/INST] hiSwelling of feet may be gravitational due to lack of muscle tone in old age bed ridden patients.There should be passive and active exercises of feet,toes and ankle and knees to mobilize muscles, do massage with olemessa oil after hot water fomentation.best wishes </s>

<s>[INST] My son is 21years old. At age 13we noticed changes in his self confidence etc... we took him to the Dr had him evaluated after many Dr visits and the put him on anxiety medicine and anti depressants. Sad to say he continues to go downhill more and more. We have tried treatment at mayo clinic, many psychiatrists and no help to make a short story out of the past 8 years. Now he rarely gets out of bed because he says he has so much physical pain. Can you please give me a direction to try. My son is very smart and always feels like he knows the questions the dr s are going to ask before they ask them and I feel like all of the drs WE have had contact with doesn t want anything to do with him. I know that there has to be a place where these type of people go to get help and be around others that ate intelligent to a scary leg I would appreciate any suggestions. Thank you [/INST] Hello and welcome to Healthcare Magic. Thanks for your query. I'm sorry to hear that your son has been doing badly despite treatment. In such cases, where multiple trials of medication fail, it is a wise thing to re-evaluate the case completely and re-examine the initial diagnosis. With the very little information you have provided about your symptoms, it is not possible to get any definitive direction about the diagnosis. I would suggest that you try to get an independent, unbiased second opinion from another psychiatrist. You can also try psychological and behavioural therapies, in adition to the medication. Wish you all the best. Regards, Dr. Jonas Sundarakumar Consultant Psychiatrist </s>

<s>[INST] Hello doctor, Since 19 months, I have had severe problems with tingling in my feet. This started one week after a 27 km run, where I suddenly got pain in my feet and had to stop. The pain went away, but the tingling started in my left foot one week later. At first, some intermittent buzzing in the outside of the sole started, but after a while, this became permanent tingling and some numbness in the same area. The problems in my right foot began a few weeks later. As far as I can tell, the problems are located in the medial plantar nerve in the right foot, and the lateral plantar nerve in the left foot. There are also a lot of muscle twitching in the right foot arch, and the symptoms can easily be aggravated by tapping on the outside of the legs, from the knee and down. Tapping on the inside of the ankles also reproduce the symptoms. I have done three NCS and EMG, but it showed no signs of neuropathy or any other nerve disease. I am taking Gabapentin and Lyrica. Please help. [/INST] Hello. Revert with more information to a neurologist online --> </s>

<s>[INST] My 5mo old has a heart murmur. I did and so did my father as well. EKG came back normal. Chest X-Rays had one inconclusive and one heart could possibly be enlarged We live overseas. They have given us the option to take him to a larger hospital for an echo but they will sedate him. His pedi says his murmur sounded better this last time and we can wait for his 6mo and see how that goes if we so choose. He is thriving, no blueing, and very happy and active. Any advice? [/INST] There is no harm in sedation and getting ECHO done at the earliest. Intensity of murmur is less significant than total presence or absence. </s>

<s>[INST] I just had a follow up with my neurologist after having an mri w/o contrast done of my brain. My chief complaint was having headaches since childhood, occasional dizziness and facial numbness that comes and goes. My symptoms are not severe but the dizziness and numbness were new symptoms so my PCP wanted to r/o any serious causes. However, he said that my mri report said no significant findings other than a “prominent pituitary gland” and didn’t have much to say as to what would cause it, after seeing my concern he offered an mri follow up in 6 months to see if there are any changes. Is it normal to have a “prominent pituitary gland” should I request a second opinion? What are the odds that a tumor or something serious was missed with an mri? [/INST] Hello, A prominent pituitary gland could be related to a tumor, to inflammation or to normal changes due to age (especially in teenagers). I would like to know your age. Anyway, considering your symptoms and this MRI finding, I would recommend checking pituitary gland hormones (TSH, LH, FSH, GH, ACTH) in order to be sure that there is no hormone imbalance. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Ilir Sharka, Cardiologist </s>

<s>[INST] hi, me and my husband are in our first month of ttc. he has type 1 diabetes and siliac. (sp) will it be harder for me to get pregnant because of it? i am currently only 100 pounds as well. i have problems gaining weight, my only guess to it is my thyroid disease . will my weight be a problem as well? doing my best to gain but its taking me a while. im concerned both will be a problem. -Amanda [/INST] Hello. Thanks for writing to us. A history of diabetes is not likely to cause any problem in fathering a child. Your body weight is also not likely to pose a problem as long as you are having normal regular periods. You should try to conceive during the fertile period during next few cycles. I hope this information has been both informative and helpful for you. Regards, Dr. Rakhi Tayal drrakhitayal@gmail.com </s>

<s>[INST] Hi, I have had groin pain that shoots down to my knee.. It happens more when I make sudden moves or at night. it also is discolored in that area. six months ago I had blood clots that are no longer there in my left groin. I have had ultrasounds done and they can t find anything. The pain is terrible, please help! [/INST] hi,.as mentioned by you the pain radiates of on the groin to the knee you should perform two diagnostic tests to check it out.One is Ultrasound of the abdomen - to check any systemic pathology which is leading to the referred pain.Two is the MRI of the lumbar spine - to see if any nerve impingement is there.Based on that he next rehabilitation plan can be implemented.RegardsJay Indravadan Patel </s>