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<s>[INST] I had a fall in late February and went to the ER. I had an x-ray and I was told I had a probable meniscus tear and given crutches and told to ice it. In May I went back to my doctor because my knee was still so painful and swollen. He sent me for an MRI which confirmed the meniscus tear and suggested a probable tibial plateau fracture. In June I finally got the CT scan which confirmed the non-displaced tibial plateau fracture. I am concerned that I have been walking on this leg and am worried that more damage has been done. It has not been suggested that I not walk on it while I wait to see the orthopaedic surgeon but from what I have been reading I should not be weight bearing. Should I be on crutches? [/INST] Dear Sir/MadamI have gone through your query and read your symptoms.In my opinion, your undisplaced fracture should have healed by now, and the meniscus needs to be handled if you have pain, and locking sensation in the joint, normally a meniscus is debrided arthoscopically and this leads to decrease in pain, but you will need good physio, if you want to recover fully.I hope that answers your query. If you want any more clarification, contact me back. </s>

<s>[INST] I am 26 years old and I am 9 weeks pregnant. Iâ??ve have had 2 miscarriages in the pass one in 2007 and the other 2009. My question is I am feeling pursuer on top of my cervix and its feels uncomfortable is that a normal feeling to feel at 9 weeks of pregnancy? [/INST] No, it's not ahappen normally. I advise you a sonography for fetal well being. Finally end with hope I have answered your question. If you have any further questions I will be happy to help you. Wish you good health. </s>

<s>[INST] my husband has a rare disease called Goodpastures auto immune syndrome . He is on a lot of medications, mostly vitamins and high blood pressure, He is on home dialysis . For the past few days he has felt jittery and feels confined and is constantly moving, even when he is sitting down he is moving his body, twisting his hands and acts like his is cold and chilling. What could be causing this? [/INST] hi your husband has probably developed end stage kidney disease due to goodpastures syndrome. For the symptoms you mentioned you need to get some tests done like urea,creat, electrolytes, calcium level. need to look if he is receiving adequate dialysis?. If on peritoneal dialysis do Cell count of PD fluid and Culture to look if he has developed peritonitis. These symptoms may be due to electrolyte imbalance or inadequate dialysis or occult infections. you need to consult your Doc. Regards </s>

<s>[INST] I had Bi-lateral knee replacements 6 years ago. Since then I been having pain at the bottom of the left toe when I walk. This happens from time to time. If I squeeze my toe I feel no pain, but when I walk it is very painful. Do you have a answer. Thanks Vinnie [/INST] hi vinnieThe toe pain may be uuunrelated to knee surgery.Have an x ray done and check up by a orthopedic doctor.it could be isolated interphalangeal joint or phalangealbone problem.Do hot fomentation and apply voltaren gel twice dailythanks </s>

<s>[INST] I have been having pains in the left side of my chest for the last few days that come and go and my left arm is numb in the mornings but gets better as the day goes on. My BP and heart rate are normal. My pains seem to subside if I drink water or eat something. Just wondering if I should have this checked out?? [/INST] Thanks for your question on Healthcare Magic. I can understand your concern. Since your symptoms are improving after drinking water and eating food, possibility of GERD (gastroesophageal reflux disease) related pain is more. But better to rule out heart diseases despite of normal blood pressure and heart rate because left sided chest pain is commonly seen in heart diseases. So get done ecg. If ecg is normal then no need to worry for heart diseases. GERD and gastritis are likely causes in your case. So avoid hot and spicy food. Avoid stress and tension. Drink plenty of fluids orally. Take proton pump inhibitor like pantoprazole on empty stomach. Don't worry, you will be alright with all these. Better to first rule out heart diseases by ecg. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. </s>

<s>[INST] I had a very hard blow to the underneath of my knee it happened about three weeks ago it bruised really bad. The bruise is gone but of anything touches a certain spot the pain is horrible it brings me to my knees. I just want to know what it could be its like a tingling pain just really sharp. [/INST] Hello, The symptoms seem to be related to the knee injury. For the pain, you can use anti-inflammatory medication such as Naproxen three times a day. I also recommend avoiding overuse of the knee. I recommend ice compresses at the area of the piano for relief. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Dorina Gurabardhi, General & Family Physician </s>

<s>[INST] MY DAUGHTER HAS ALL THE SYMPTOMS OF BREAST CANCER BUT DOES T HAVE ANY HEALTH INSURANCE AND IT DOWN TO ONE DAY A WEEK AT HER PRESENT JOB. SO SHE NEEDS SOMETHING REALLY CHEAP OR FREE. WE LIVE IN ALABAMA. SHE REALLY NEEDS TO BE CHECKED OUT. CAN YOU HELP HER? [/INST] Hi, dearI have gone through your question. I can understand your concern.First of all she should go for fine needle aspiration cytology or biopsy to confirm the diagnosis. Treatment depends on stage of cancer. She should go for mammography also. If it is cancer then she should take chemotherapy. Then she should go for surgery. Modified radical mastectomy with lymphnode dissection is the treatment of choice for surgery. She should also go for her ER, PR and her2neu status. If this receptors are positive then receptor antagonist therapy is helpful. Consult your doctor and plan accordingly. Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health. </s>

<s>[INST] in nov my cxr showed marked diffuse interstitial lung dz, in dec i had a chest ct scan that showed severe scarring tgo my upper lobes and lower lobes,lesion to rul. i have on and sob with cough and wheezing, emphysema to lower lobes and mild pul congestion in march this year. s/s cont at this time cxr shows opacities to both lobes and nodular densities th both sides. my dr says its pneumonia. i need another view. 2 yrs ago i had endometrial squamous cell cancer with tahbso done and no further sign of cancer. should i concern myself whether this could be cancer? [/INST] Thanks for your question on HCM.I can understand your situation and problems.In my opinion you should consult pulmonologist and get done bronchoscopy and BAL (Bronchi Alveolar Lavage) analysis with biopsy from the involved area.As possibility of malignant spread (lymphatic) is high. And this can also gives same CT picture. This can also seen in pneumonia.BAL and biopsy will diagnose both.So better to consult pulmonologist and discuss all these. </s>

<s>[INST] I was moving a heavy machine with a hand truck and fall over backwards.my leg was black and blue badly but cleared up.now my knee keeps me up at night, this has been 3 month ago now.so in the morning it is bad (pain) but the end of the day not bad.but at night it kills me the wight of my other leg on it or just the i am sleeping thanks Clyde in Rhode Island [/INST] If you want you can use castor oil application in your affecte area it will gives your relief from pain....if possible take calcium suppliment for 2 month. Therre may be ligament injury which causes pain and if it. It will heal in long duration upto aatleast in 6month. Now lubrication or oil massage is best to heal soon </s>

<s>[INST] My sister is a user of meth and now she is in the hospital getting her gallbladder and one foot of her small intestein removed. She has told my parents that she has chrones disease and that is why she is having stomach issues could this be true or infact a result from her using meth? [/INST] Dear Enquirer You mensioned your sister is meth user I think you mean user of Methyal Amphetamine.The side effect of Methyl Amphetamine includes intense euphoria, severe dental problem, severe emotional problem, violent behavior, paranonoid attitude , decrease appitite severe loss of weight but does not devolop any condition which needs surgical intervention. Crohn's desease is inflamtory bowel desease which affects both small and large intestine and usually present with abdominal pain, persistant watery diarrhoea some times constipations and rectal bleeding. Needs lots of special tests eg colonoscopy, barium enema, CT scan of abdomen,MRI scan. The person got Crohn's desease need to take and use special medications eg pain killers, aminosalysilates antibiotics by mouth and needs to use steroid enema. If there is blockage in the bowel due damage or stricture that section of the bowei got to be removed by surgery. I therefore feel your sister may have got Crohn's desease and this condition is nothing to do with her meth taking. Regards. </s>

<s>[INST] my T6-7 T7-8 is buldging and if I do not do anything its just that area that hurts but if I do any kind of lifting, cleaning etc the muscles to the right flare up and hurt real bad as well, is there any reason that is happening and when I take a deep breath I can feel it in my chest [/INST] The weight causes undue pressure on the spinal column which may in turn cause mechanical compression of the nerves in the thoracic spine region which relay signals to the areas of the upper back and chest region. Unfortunately, this will continue to be the case until you address those bulging disks, reduce the amount of weight you lift, or retire from the sport. No other options....oh of course, there are pain medications but these are poorly effective to PREVENT pain and really not designed for that purpose so you'd have to take a lot of drugs on a constant basis that could affect you in other unwanted ways. If this information has been useful to you then, your written feedback as well as a STAR RATING to the question would be greatly appreciate.If you would like to ask more questions in the future then, you may contact me at bit.ly/drdariushsaghafi. </s>

<s>[INST] Hi, I haven't been able to lie down for 4 days now with a cough that becomes terribly hacking when I lie down (only 12 hours sleep in the last 4 days). Even stretching my neck or yawning can bring on an attack. I also have a green/black tongue, all over the tongue that lightens when I brush the tongue but doesn't go away. The cough seems to be caused by a circular process of nasal drip down onto inflamed , sore and sensitive lower throat tubes (the bronchial tubes?), which causes a cough, which makes the throat more sore and sensitive for the drip to trigger again. If I do manage to sleep and am woken with a cough I bring up hard to shift green phlemghI also have a blocked nose that doesn't produce anything when I blow my nose. [/INST] HI, thanks for using healthcare magicThe fact that the cough worsens on lying down may imply that there is pooling of secretions.You may need to consider a decongestant, antihistamine and mucolytic.The decongestant would help relieve your nasal symptoms and by reducing the dripping of mucus, help reduce the coughing.Mucolytic would help to break up any mucus so that it can be easily expelled and the anti histamine would also help with the mucus and congestion.These should be available over the counter and may be combination.Examples of oral decongestants are pseudoephedrine and phenylephrine.Examples of mucolytics are guifenesin, bisolvan, mucomystI hope this helps </s>

<s>[INST] Hello I'm 43 years old and my height is 5 feet and 5 inches tall. I am inquiring about an allergy/sinus issue that I've always had since I was little but seems as though now that I'm getting older the issues are getting more problematic. well within the past few months or so I've been experiencing swelling in my sinus area on the left side of my nose with pressure after experiencing a headache, runny nose, burning sensation and water running eyes. I really need to know what can I do other then taking antibiotics and promethazine to resolve this miserable feeling that I have lately.. Any suggestions would help me greatly., Thanks so much!!! [/INST] Thanks for posting your query to Health care magic .you should rule out cause of sinusitis . You should undergo radiological(X-Ray) and endoscopic examination of your sinuse area to detect abnormality . Second you should avoid expouser to dust ,cold air and water to your sinuses as these thing irritate the sinuses and aggravate complaint .if any abnormality detected go to ENT surgeon for any surgical treatment .Hope I have answered your question. If you would like some more information I will be happy to provide. You can also write a review for me. Wish you good health .Regards,Dr.Manish Purohit </s>

<s>[INST] I had surgery with scope down thought now I have bumps on back of my tounge what s wrong?they all had inital first namesthere middle names were biblical names there was J.D. my biologicalthey all had inital first namesthere middle names were biblical names there was J.D. my biological dad an R.C. an J.C. an a few more i probably forgot dad an R.C. an J.C. an a few more i probably forgot [/INST] Would like to clarify whether there is any physical form of swelling or loss of sensation. Physical form of injury could be related to localized trauma during procedure. Loss of sensation could be attributed to lingual nerve injury, the nerve that is partly involved in sensation. You might have to take an opinion from a neurologist. </s>

<s>[INST] My mom recently had a rdaical nechrectomy on her left kidney back in Nov. She is on hemodialysis due to her other kidney being so small. Before this recent diagnosis she was a very healthy active 63yr old woman. My question is this. For the last couple of months she has been experiencing extreme diarehha. It has totally disrupted her life. She says she generslly has no pain and it just happens. It actually runs down her legs and she says sometimes there is clear jelly-like substance. She had her stool tested by her pcp, came back negative. SHe is scheduled to have a peritoneal line put in for dialysis this week. I am concerened and thinks this should be addressed before the surgery. She sometimes has nausea and vomiting associated with it, but at other times her diarehha is the only symptom. I do not tink this is associated with dialysis. Could something have happened during her nechrectomy? Thanks for listening. [/INST] Hello and welcome to HCM.As an Urologist, i can fully understand your concern.You haven't written,why she had her left kidney removed.As she's in CKD(chronic kidney disease or failure),she'll need maintainence dialysis or a kidney transplant.Yes, dialysis does cause diarrhoea. So her electrolytes will be checked daily or alternate days along with creatinine,otherwise, she could become dehydrated. It's not attributable to her nephrectomy, in any way.Hope your doubt is cleared.Dr.Matthew J. Mangat. </s>

<s>[INST] sir,my name is deepraj naik,from goa india,age 23 years, height 173cm, weight 56kg. Dr. said their is infection in my ankle joint, i have a problem in my left foot from last 8 days, it looks like their is no sense in my foot.. it started from toe and reached upto my knee within 8 days. i really worry about this... i am waiting for your favourable reply... [/INST] Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.If you are not feeling sense in the feet than it is the matter of concern.I suggest you to visit the ER immediately. Many a time infection causes anaerobic bacteria to grow on infection site which creates gas and further causes sensation impairment.Such changes can lead to gas gangrene and requires a amputation. So as if you visit the hospital immediately than you can prevent it from spreading upwards.I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM. </s>

<s>[INST] I went for 2 semen analysis and the first one showed that my morphology is 2% normal an 98% abnormal and he 2nd one I did a week later and the result was staggering as my morphology came back 1% normal and 99% abnormal. What should I do? shoud I do a 3rd test? I am 45 yrs old and my wife is 36 yrs old and we have been trying to have a baby for 6 months now. please advise [/INST] HelloThanks for query .Based on the report of your successive semen analysis done over interval of one week has revealed you to have what is called as Severe Teratozoospermia meaning there by only 1 % of the sperm in your semen have normal morphology .The morphology of the sperm plays very important role in effecting pregnancy .With given abnormality of the sperm and your and your wife's age there are no chances of natural pregnancy.I would suggest you to consult qualified Infertility specialist to explore the possibility of pregnancy with the help of newly assisted reproductive techniques like IVF or ICSI.Dr.Patil. </s>

<s>[INST] doctor my daughter is 10yrs old and admitted to hospital and diagonised as amebic liver abscess, metrogly is been giving including other antibiotic for the past 11 days and the pus was drained using (Ultra sound) by niddle aspiration two times, and our doctor told us that, the pus has been removed completely second time, and pus may form again or it may not. Please advice us doctor, after two complete sucessful aspirations why the pus again form and till how long it take to cure completely, pls. advice and help in this regard. thankyou kumar (hyderabad-india) [/INST] Hi and welcome to Healthcaremagic. Thank you for your query. I am Dr. Rommstein, I will try to help you as much as I can.Pus is formed because not all the pus is evacuated last time and small parts of parasites are left in liver. Treatment of amebic liver abscess may be long and difficult and usually metronidazol treatment isnt sufficient so aspirations may be required. even aspirations may be unsuccessful and as a last option, surgical drainage can be performed so you should consider this with your doctor especially if sepsis or ameba dissemination occur.I hope I have answered you query. If you have any further questions you can contact us in every time.Kindly regards. Wish you good health. </s>

<s>[INST] my son is a 9 mnths old now, he had been confined to a hospital for two days on a diarhea last two weeks, he take a lactosefree milk and his poop is ok, now i go back to his old usual milk not lactosefree and he didnt want to take it nicely, now he didnt take a good sleep and had a lowgradefever andhas a husky voice, hope somebody can have an answer for us, thanks [/INST] Hi.... I understand your concern. By what you say I feel that your kid might be having a viral diarrhoea. This sort of feeding pattern is very common till it gets adjusted.I will tell you how a viral diarrhoea behaves, so that you will feel more confident.Once it starts it will take 5-7 days to completely get better. Unless the kid's having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry.Regards - Dr. Sumanth </s>

<s>[INST] For the last 2 months I have been short of breath, cough or gasp when talking and or doing activities. Around the same time I also have noticed that it feels like my heart is slowing down then pounding sometimes feels like it is skipping a beat and I can feel it on my right side of my chest. They do not occur at the same time but the feeling in my chest is happening more and more each day. It occurs when I am resting, relaxing on the couch and with activity. Do I need to see my doctor? (sometimes I have a dizzy spell) [/INST] Thanks for your question on Healthcare Magic. I can understand your concern. By your history and description, we should definitely rule out heart diseases first. Because your all symptoms like shortness of breath, cough, pounding of heart, missed beats etc are characteristic symptoms of heart diseases.. So consult cardiologist and get done 1. Blood pressure monitoring 2. Ecg 3. 2d echo 4. Holter monitoring (24 hours continuous recording of ecg) 5. Stress test (trade mill test). You will need cardiac supportive drugs on the basis of these reports. Don't worry, you will be alright. But first rule out heart diseases. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. </s>

<s>[INST] Hello doctor, My last period started a month ago and ended four days later. I had sex with my partner two weeks after I got my periods. He did not ejaculate inside me but to be on the safer side I took an I-pill within two hours. Now, I am two days late and I have a brownish discharge since yesterday. I thought it was my period. But it clearly is not. What is it? Could there be a chance that I could be pregnant? [/INST] Hello. The days you mentioned are nearing the ovulation period. In a patient who has normal regular cycles of 28 to 30 days, ovulation occurs on the 14th or the 15th day when chances of pregnancy are high if you have sex on those days. You have said that there was no ejaculation inside the vagina and you have already taken an I-pill (emergency contraceptive pill) within two hours. So, there are very rare chances of pregnancy. Your current period is late for only two days and you have a brownish discharge. Sometimes due to stress, periods get delayed. You need to wait for four to five days more and I think you will start proper period. But if you do not start your period within a week then you need to do urine pregnancy test. I am sure you will start your periods. Stress is a big factor for delayed periods. For more information consult an obstetrician and gynaecologist online --> </s>

<s>[INST] I am experiencing pain on the bottom of my left foot in the arch area. For the last month or so I have had a knot in my arch and now I am experiencing some pain. The knot is not as large as it was but I feel more pain. I wore some clog type shoes one day this weekend and I felt sharp pain on the top of my foot almost to the point of not being able to walk only momentarily. [/INST] Hello,What I can conclude from the complaints you have mentioned is that you have symptoms of plantar fasciitis? It’s a common condition usually seen after use of improper footwear or excessive strain of the foot ( usually when You suddenly start exercising for ex. jogging and walking). I would suggest you to 1. Wear soft footwear with well-padded heels or MCR footwear. 2. Hot fomentation (dip both your feet in lukewarm water for 10 to 15 min twice) local pain relief gels. Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Santosh S Jeevannavar </s>

<s>[INST] Hello doctor, I am 21 years old. I am having suicidal thoughts and not able to get into a parking space. I am a new driver, and I am scared that I will die while driving. I also feel like I am low than other people. I am having this problem for a several years. I have OCD, depression, and generalized anxiety. I was taking Luvox, Prozac, Zoloft, Lexapro. I am currently taking Cymbalta 20 mg. What can I do? Please help. [/INST] Hello, Welcome to icliniq.com. You appear to be less confident and excessively worried about driving. Many young drivers feel the same, but you appear to be more affected by anxiety related to driving and parking. Always remember that you will get better with experience. Try to drive at a slow pace for the first one to two years and practice parking maneuvers untill your confidence is better. You can seek support from an experienced driver or take some pass-plus driving lessons. You are reporting a history of anxiety, OCD (obsessive-compulsive disorder), and depression. I note you have been tried on different antidepressants. In addition to the medication, you can try psychological therapy and CBT (cognitive behavioral therapy) which will be very effective to manage your excessive anxiety and build your confidence back. I hope this helps. </s>

<s>[INST] when I was a child and traveled to far eastern countries with my da I had to have TB vaccinations at least twice and booster shots. Now I am told by VA that I need to get treated for inactive TB in case I have respiratory problems later. Is this true and do I really need the Isoniazid treatments? [/INST] Hi, As per the WHO guidelines, the inactive TB does not require a full course of AKT provided no symptoms , signs or other data suggestive of least activity of the tuberculous pathogen. Hope I have answered your query. Let me know if I can assist you further. </s>

<s>[INST] Hi, Im a 27 year old married lady. I was diagnosed with diabetes and hypothyroidism when I was pregnant during 12 weeks. My HBa1c came to level 9, so my gynaec suggested to reconsider my pregnancy, because of the risk factors involved for the baby. I went through a medical termination. I still cannot get over it emotionally. I am working and sometimes have a hectic schedule. I get stressed and emotionally drained, which leads me to eat a lot a times. I want to have a baby but somehow I am not able to have a steady diet and a healthy life style. Can you please help me? [/INST] Hi, I think you should do some yoga and meditation . Relax for sometime. Take a break. Have a healthy diet. Consult a dietician for control of sugar levels. You can start some oral hypoglycemics also. Try for pregnancy once your sugars come under control. </s>

<s>[INST] My father fell on his shoulder & is in a lot of pain. He can t move it at all & has difficulty getting up, moving & using one arm. Could it be broken, sprained or rotator cuff? There i=s a bruise on the arm. It may be a little swollen, but doesn t look like it. Arielle [/INST] Hello there I have read through your question and would like to tell you that pain and swelling along with inability to move the shoulder joint all point towards a diagnosis of fracture. I would advise you to get his XRay shoulder joint done as soon as possible as delay may lead to complications. Meanwhile it would be better that he doesn't try to move the shoulder too much and keep it restricted with the help of a strap. I hope that answers your question. If you have any further questions please feel free to write. Thank you for choosing healthcare magic. </s>

<s>[INST] hi doc,i think i m in gr8 problm,i havin pain in abdomn thats for mensuratn n havin food poising think soo,i drank 2 hrs ago d redbull n few aftr few mins i drank a glass of milk,n now havin pain in both lowr n uprr stomach,n loose motn for 20 tyms,i m nw havin ors bt it didnt help..wht cn i do?? [/INST] HI.Thanks for your history in a proper way. 20 loose motions ?? Rush to ER / Hospital'Get vitals checked, get admitted for intravenous fluids for correction of dehydration, get proper intravenous antibiotics and supportive medicines. Add on probiotic and activated charcoal tablets, bananas and curds. You may need investigations:Blood for infection,Urine and stool.Ultrasonography if needed. Do not be in a hurry to go home until the emergency is completely over. </s>

<s>[INST] i need help finding out whats wrong with my girlfriend. she has abnormal pains in her eyes at night every night, which she explains as needles in her eyes. She also suffers from trembling and dizziness, thats not seizure like because she is aware , yet it affects her emotions. sometimes its a faint spell.finally she has a lymph node that has been swollen for months thats the size of an olive but not quite the size of a grape. I might add hse has had mono and swine flu but got over them both. i need to find the answer because all the doctors around here are saying shes fine, but she says theres something wrong. might i also add someone poked the back of her neck close to her skull when she was younger and that caused her to seize ( i think) and since then she supposedly cant remember dreams at night. i think anyone can vouch that when a loved one is in pain, thats the worse pain you can feel. [/INST] Might be she has something wrong going on in the mind saying always I am having some problem which none else are able to find it out. Take her to a Psychiatrist. </s>

<s>[INST] i am(36 years female) wt 67 kg ,height 5'4'' with sjogren syndrome and positive ANA tested in 2005 , RA factor tested 60 , the sliva and dryness is almost cured by homeopathy since then but now suffering from low grade fever 99-100 since last 3 months.hot sensation is on face ,palms and feet sole , Hb is 11.5 ,feeling tired , mild swelling in fingers after long working and lower back pain. [/INST] Hi, dearI have gone through your question. I can understand your concern. You have sjogren's syndrome. So your symptoms are due to that. It is autoimmune disease. Treatment is immunosuppressive drugs like steroids. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health. </s>

<s>[INST] Hi I am 30 yrs old lady, before one bchmonth i was suffering from typhid....after 1 week i got stomach infection then it was gone after taking precaution, then again after week i have got stomach pain...what should i do i want to ask why again again stomachache is occuring [/INST] Either you have some other infection and not typhoid or you have a chronic typhoid carrier infection. For both the possibilities you need to get investigated thoroughly by blood reports and a USG of the abdomen. Meet a physician and discuss </s>

<s>[INST] Hi, my daughter is almost 8 and we have noticed that her coccyx is very scew, it is completely off-centre and almost makes an upside down L-shape. Do we need to do something about it, or does she just have to live with it. She hasn t complained of any back aches [/INST] Hello and Welcome to ‘Ask A Doctor’ service.I have reviewed your query and here is my advice.This is a normal finding. However, an examination by Orthopaedic surgeon should be done.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Deepak Patel </s>

<s>[INST] had decompresion surg on L4 and L5 in dec...then infection 10 days later not merca they cut me open cleaned it out 8 days in hospital 6 weeks at home iv bage now 4 months later still crazy pain in back legs calfs ...fingers toes knees im 43 male and active also did 8 weeks physcal theropey ready to move on will this pain get better or will it be with me for life...my dr says im doing good and it will take a year to get better no mri or cat scan or xrays sence infection i wonder what kind of damage i have giving me all this pain i run heavy equetment for a living and need to go back to work [/INST] Hi!Thank you for writing to usThere are chances that some neuro muscular pain is because of neuropathy, i would suggest a neurologist consultation.if i were to treat, i'd like to see a new mri and neurophysiological tests done, An Emg study as well and advice for blood sugar tests., if its neuropathy then pregabelin, methycobalamin, vitamin B1+B6+B12 injections would be preferred.Please consult your doctor and if he agrees, proceed for further evaluation as suggestedThanking youBest wishesDr sunil srivastava </s>

<s>[INST] I am 45 years old . I have been experiencing a sharp pain in my right lower side (like a pinching) along with some heartburn, belching, and lots of gas. Sometimes my lower back hurts as well. I do have acid reflux and have always had stomach problems. I have seen my doctor and he is treating me for IBS. I am very worried about this, but he tells me it takes some time for this to get better (maybe months). What I have noticed is that I feel great for most of the month, but then about a week or so before my period is when it bothers me the most. [/INST] HI.This may not be IBS as your pan increases about one week before the periods. This is more suggestive of a problem with hormonal effects. I would advise you first to get in consultation of a Gynecologist, to undergo clinical examination, ultrasonography and blood and urine tests. Diagnostic Laparoscopy can help for the diagnosis and treatment too. IF this is endometriosis or tuberculosis of the abdomen, you will need definitive surgery and medical treatment. </s>

<s>[INST] Hello! I have a question last night I was going to bed and when I put my head on the pillow I got this very sharp pain in the right side of my head. It almost felt electric and my right arm went numb. I got very scared I have never experienced this before [/INST] Hello dear,I understand your concern.What was the duration of your symptoms in this episode?For single episode of sudden onset headache with numbness in right arm ,the organic causes can be some seizure activity, a transient ischemic attack or a rare variety of migraine.However,it needs to be observed, whether you have any such episode in future,before getting extensive investigations.A neurologist opinion may be sought,so that he may examine you and advise further.I hope it helped. </s>

<s>[INST] Is there any research that points to the use of Saw Palmetto as an anticoagulant for AF therapy? I have been prescribed Eliquis 5mg BID, received a free 30 day supply, but most likely won t be able to afford it. I experienced GI bleeding when I took Pradaxa. I am a 75 yr old man diagnosed with AF appx. 10 yrs ago. Thanks, gary [/INST] Hello sirIn my opinion, saw palmetto is basically the American dwarf palm tree. The extracts of its fruit have been used to treat benign prostatic hypertrophy in elderly. However, international guidelines as based on various large centre clinical trials DO NOT recommend its use.For Atrial fibrillation, there is NO ROLE of saw palmetto. As a professional advise, I would recommend you to continue on oral anticoagulants. There are multiple options available suiting your affordability. Pl discuss the same with your cardiologist.Thanks </s>

<s>[INST] sir i am diabetic paitent age 63 yrs from last 15 days i am felling exerted, also get exhausted and feeling tierd and body get sweeting while some physical activity such as walking , also done ecg and 2d echo from cardiologist ,report not showing any abnormalities ,what should i do now, [/INST] Hello!Welcome and thank you for asking on HCM!I understand your concern, and would explain that your symptoms may be related to a autonomic neuropathy. Have you measured your blood pressure lately? A low blood pressure or orthostatic hypotension could explain this clinical scenario. I recommend consulting with your GP for a careful physical examination, a chest x ray and some blood lab tests :- complete blood count ( for chronic anemia or a chronic infection). - HbA1C (to identify the mean blood glucose values of the last 3 months)- fasting glucose- kidney and liver function tests - thyroid hormone levels ( a thyroid dysfunction could also mimic these symptoms)- cortisol plasma levels (to examine the adrenal gland function)- blood electrolytes- inflammation tests (PCR, sedimentation rate). A head up tilt test may be necessary to confirm a possible orthostatic hypotension if suspicions are raised during the physical exam. Meanwhile I would advise you to take plenty of water and juices and a balanced diabetic diet.Hope to have been helpful!Best regards, Dr. Iliri </s>

<s>[INST] Went to ER today with my boyfriend. He has huge hard lump that's bright red on lower right side close to spine. It's hurts him badly. Dr tried to drain it with nothing coming out at all. Told us to come back on Wednesday to check it. Gave him 2 antibiotics. What could it be??? [/INST] HI. This can be a cellulitis , that why nothing came out.Continue antibiotics and anti-inflammatory medicines. Get an ultrasound done to confirm it is ripe enough to put in a needle. </s>

<s>[INST] One breast has an abnormal nipple (inverts or appears flat when I stoop over) and I am wondering if scar tissue from multiple biopies could cause this. Also, this has been like this for a few years. The radiologist reported "abnormal nipple" at my recent mammogram. Also, there was a cyst revealed at a previous mammogram and ultrasound. Nothing was done to this cyst. It was just left there. [/INST] HelloWelcome to healthcaremagicInverted nipple can be due to so many different causes.This includes congenital,trauma ,infection caner etc. Although breast cancer is one of the cause of nipple invertion,it is not the only cause.Since your mammogram was done recently and it doesnot show anything abnormal you can be assured that it is not serious. Plastic surgery can be done if you opt to correct it.But you need to have your mammogram routinely as prescribed to follow your nipple and cyst.Regards </s>

<s>[INST] I was intentionally cutting my face with an old razor kind of dirty over the same spots on my face deep enough to cause blood when it would start to heal I would do it again.Never looked like I had an infection.I had night sweats and grinding my jaw all the time and I have swollen lymph nodes under arm and in groin.Could Thisbe the cause of tetanus? [/INST] Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. As per my clinical experience, the rusty old razor can be the cause of tetanus. I recommend you to immediately consult your physician for further management. Wish you fine recovery. Hope I have answered your query. Let me know if I can assist you further. </s>

<s>[INST] I was diagnosed with yeast infection in my vagina and treated by my PC. I ran out of the ointment he prescribed and now several days later, I am very uncomfortable with burning in both my vagina and anus and also some swelling of the vaginal labia. I m thinking of doing a cool sitbathe until I can be seen in a couple of days. Which is better cool or warm? I won t do either until I hear from you. My e-mail address is: YYYY@YYYY Thank you in advance. Dorothy J. Britto [/INST] vaginal yeast infection can be treated using anti-fungal medication.Vaginal antifungal medicines, such as miconazole (Monistat) and tioconazole (Vagistat) will cure the disease. Also, don't clean your vaginal using soap but use water only and also sitz bath in warm water helps. </s>

<s>[INST] Hi I am a 45 years old female from India.Since sometime I have been experiencing intense pain when I try to drive .The motion of the foot at the accelerator causes this pain which goes up to the calf and the muscle gets painfully tight.I have also have pain on my upper foot sometimes a slightly burning sensation .when walking too I get this discomfort and it feels better at times when I flex my foot upwards.It happens in both the feet but started with the right....any help? [/INST] This mostly symptoms of hypocalcemia ,so you should take mixture of vit.D and calcium tablets once daily for 6 weeks and take milk, cheese and meat daily. </s>

<s>[INST] I Have recently noticed White patches around my inner thighs, scrotum and penis. Although, It hasn't shown any harm, no itches or anything of that sort, but I was wondering if this is something that will go away, If so could you tell me how and what this could be. For the record i'm only 17 years old, incase that means anything, Thanks [/INST] dear sir, this might be 1) lichen planus or lichen sclerosus which is idiopathic condition with no known cause.. they are associated with itching so unlikely in your condition2) if they are raised above the surface of skin.. this might be due to poor shaving habits or infection of hair follicles which is known as folliculitis..this will resolve with good hygiene and an antibiotic cream3) this is unlikely to be sexually transmitted, because STDS are always painful4) pilar cysts that appear aa white dooms, if small leave untreated, if large visit a doctor for their removal </s>

<s>[INST] I have upper back pain going thru my chest and nipples hurt. im 29 years old white male 290lbs. went to er room. had chest ex- ray everything is fine, blood work is fine and ekg is fine. dont know what is going on back it hurts. any quess what is going on. the doctors didnt have a clue what is going on. [/INST] Hello,I had gone through the case and found that it might be due to muscle spasm which causes nerve trapped.So take mild painkiller and apply muscle relaxant gel.Hope my answer will be effective for you.Thanks; </s>

<s>[INST] out of no where i got a big fluid filled bump on my back, its soft and looks like when you burn yourself and it swells up, it stings and around it is a small red circle and near the spot i have like 5 small red flat dots about the size of a pimple???? [/INST] does it pain.if yes ,it could be herpes zoster.no pain means allergy.apply calamine locally.if not cured wait for a week.consult your doctor.he will examine physically,make the diagnosis.treatment. </s>

<s>[INST] ill I can't find any android app that will tell me what's wrong with me u just click q body part... so I was on the phone last night and I started to get a swore throat... but I just thought it was from not having a drink... so I when to sleep and when I woke up this morning... it felt like I had a lump in my mouth/throat I couldn't get out of bed... I was dizzy if I just moved my head... I had a headache... my ear hurt when I swallowed... I couldn't tell if I was hot or cold... my sense of smell is off (everything smells different)... my mum got me a paracetamol and I am feeling well enough to type this but that's it I still can't get up... I am a 19 year old male and I'm just wondering if there's any way to tell what's wrong with me... thankyou for your time. [/INST] Hi dear thanks for the query on HCMYour query suggests you may have tonsillitis. You need to visit a physician. He will examine your throat and the neck.and suggest the treatment.Till that time do salt water gqrgle in warm water thrice a day.Eat warm food and lotsnof warm lemon juiceThank you </s>

<s>[INST] hi,i ahve done root canal for my left upper firsat molar 2 mtnhs agao as i was having sever pain, and the doctor said it was infected.then he fixed cap for the same. but the pain didnt subsidzed. i was on contrionus pain killers.then he removed teh cap and he called a endodontist. he also did soemthign on my tooth. but yet pain was not going. one day it will not be tehre next day it will cumat last teh doctor decided w ell remove the tooth. and he extracted the same.1 week wound pain was there and after that it was better. i was not eatign that side.but these days i do slight sensitivity and pain over there.i feel pain over the next tooth also. but whne took xray he said ther eis no infection in any other tooth.after extraction how many days the pain will be there. [/INST] Hello there , Thanks for writing your query, Extraction of tooth often ends with complications like pain and swelling post extraction . usually it takes 7 to 10 days for the extraction wound to heal and close completely provided if there is no infection . After extraction antibiotic and analgesic coverage is must to prevent infection of the extraction site and to promote healing. i would suggest you to start with a antibiotic and analgesic course consulting your dentist , which helps in subsiding the swelling and relives post extraction pain. follow all the post extraction instructions and rinse the mouth with lukewarm saline or antiseptic mouth rinse. i hope this helps , take care. </s>

<s>[INST] Hello doctor, I have a surgery for rolando fracture tomorrow morning. I am a bit worried about this. I was given meth during a dance festival, day before yesterday evening. I went and got a drug test just to make sure and have been up since then and am hoping I can fall asleep at least a few hours tonight. I had quite a crazy first experience but am very ready to be down and have surgery at 10 AM in the morning. I do not want to take any risk, as it is obviously not worth it. It would have been about 18 hours since the last use of meth. At the time of surgery should I tell anesthesiologists about this? Is it safe to undergo surgery? Please advise. [/INST] Hi. I have read through your query in detail. Please find my observations below. Hope this answers your question.  Consult an anesthesiologist online for further follow up --> </s>

<s>[INST] Hi a cousins husband had abdominal pain and went to see his dr. They did a CT, and endoscopy. Saw pancreas was atrophied. Dr. felt had been this way for 20 years. A1c Hemoglobin level elevated to 7. Hasn t seen a specialty dr. yet. No previous problems. Not a big drinker, etc. no Nausea , no vomiting, no wt loss. he has essential tremors. Who should he see, and would an other test help see if other organs are involved. or if pancreatic ducts are blocked, etc. I m A NURSE, BUT THIS IS NOT MY AREA. [/INST] Hi.Thanks for your query.Very true, we have to confirm the diagnosis. The best ways are::MRCP and Endoscopic USG. This will confirm the diagnosis.The blood tests are not of importance in chronic cases.You have to see:Gastroenterologist and Neurologist for essential tremors.This condition appears in fatty infiltration of pancreas. It is better be confirmed as is the blood sugar levels to be monitored. </s>

<s>[INST] I found a random red mark on my hand but it has a white spot which is where my bracelet was and the rest is red but it s not everywhere it s just in one spot and it hurts a little when I touch it, it feels like a burn I found it yesterday morning and today a random huge red mark appeared on my forehead that feels dry but doesn t hurt what can this be? [/INST] HIWell come to HCMI really appreciate your concern, such skin red mark could be due to contact dermatitis and it can be well managed with "Mometasone cream" avid wearing the gear till it get alright and this is nothing to worry, hope this information helps, take care and have a nice day. </s>

<s>[INST] Hi doctor, Before the vaccinations, I was in good health and optimal fitness level. The Hepatitis B vaccine caused me an unresolved encephalopathy and symptoms of autoimmunity. It caused flu-like symptoms, including malaise, sore throat, diffuse musculoskeletal pain, extreme exhaustion, numbness of both feet, abdominal pain, diffuse myalgias, arthralgias, and fatigue. I also had problems with cognition and concentration. The mild numbness I had in my hands after vaccination has spread, and I developed burning, lancinating pains in my arms and legs. It is painful to even wear shoes. I feel electric shocks in my arms and legs, and heaviness in my arms and legs got worse. I feel as if I have the flu every day, and all my muscles hurt. I am dizzy and light-headed. I have intermittent problems with numbness and tingling in my arms and legs, clumsiness in my right hand, trouble running, painful jerking of my right arm, and a low energy level. Overwhelming exhaustion that rest does not improve. I also have short-term memory loss, difficulty with attention span, low-grade fever, and rapid heart rate. The shoulder pain inhibits my ability to do chores and to groom myself. Afterward, I started to struggle with dressing and lifting my arm. The shoulder pain onset was gradual, and I have body aches, frequent muscle tension, severe muscle weakness, muscle spasms, and soreness across my shoulders. I feel less coordinated, and have pain under my left arm, severe frontal and parietal headaches, and nausea. I feel weak from shoulder to the elbow of my vaccinated arm, sweats, chills, joint aches, and stiffness. There are some unusual pains down the sides of my fingers, and inconsistent tremor of my right hand greater than my left. I also have vertigo, abnormal involuntary movements, memory loss, weakness in my left arm and left leg, and an inability to exercise. I get very ill when I try to exercise. According to my doctor, molecular mimicry is a potential mechanism for these adverse events. In such cases, a vaccine specifically activates cross-reactive T cells or antibodies that initiate a process, which ultimately injures the host’s nerve tissues. My GP said it is to do with 'nerves' and he referred me to a neurologist. The list of investigations that would prove worthwhile is deltoid muscle biopsy, plasma creatine kinase levels, MRI shoulder, EKG, nerve conduction studies, and brain perfusion scan. Should I order any more tests? [/INST] Hello. Revert with more information to an internal medicine physician online --> </s>

<s>[INST] i am 28 years,trying to cocieve since 9 months,prolactin was high but now controlled with cabgolin dosage.got my ovulation study done today,20mm dominant follicle on right ovary and 13mm on left ovary,but endometrial thickness is 4.6mm.have been given progynova 2 mg for 3 days.i want to ask if i need to take 3 medicines daily or 1 medicine [/INST] Hi,Thanks for your query. I read your query and I understand your concerns.Following is my reply:1) You need to take 3 medicines daily.2) The tablet is to improve your thin endometrium.3) Endometrium should be more than 7 mm for success of treatmentI hope I answered your query.Write back to me if you need more clarifications.Regards,Dr. Mahesh KoregolIVF & Infertility Specialist </s>

<s>[INST] hello, im under infertility treatment. I was given 3 fsh injections and on day 14 my follicle size is @ 35 mm and endometrium thickness is @ 11 mm. Now I had a HCG shot 10,000 units. Could you please tell me whether 35 mm size can release a egg and could it be still a follicle or just a cyst? FYI - I had a laproscopy in order to puncture my cysts 2 months back... [/INST] Hi, 35mm follicle might be just be a cyst. But more importantly, if you didn't have cyst in previous scan of this cycle, it might indicate corpus luteum (formed after follicle is ruptured). Considering the second optimistic property you can go ahead with treatment. </s>

<s>[INST] I am a male, 58 years young and in good health and shape and about 30 minutes ago after I got out of the shower I noticed an indentation on my forehead from the top of my scalp to the middle of my forehead! What is this, what caused it and how can I get rid of it ASAP?! Thank you. [/INST] Hello, Welcome to HCM. If you did not bang your head, you probably have it for some time. You should see a plastic surgeon who might correct it with Botox injection or with filler. If it is not correctable with these, you may require plastic surgery. </s>

<s>[INST] Hello my name is Robert. My wife Courtney has been suffering sinus congestion, sore throat, chest congestion, ear aches and lots of coughing for about three days. She has been taking antibiotics, Sudafed, and over the counter cough medicine. She is still feeling pretty bad. Any suggestions? [/INST] Hello,Sudafed contains pseudoephedrine to combat sinus congestion.In our clinic, we recommend additional support of inhalation of boiled water vapors with added tincture benzoin and gargles with salted lukewarm water added peppermint oil 3 times a day.You may require a change in antibiotic or doctor visit as per the progress.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Bhagyesh V. Patel </s>

<s>[INST] Hello Doctor, my name is Zainab Chunawala and I am 25 yrs old. I was married in 2004, and have a baby girl of 4.5 yrs old. Now I am planning for a second child since last 4-5 months. I even visited my gyn. She had suggested to go for a follicular study. My last cycle started on 26th June and then I conducted the Follicular study from 2nd July -till 8th July. Then the doctor told that the eggs are rupted on 8th July and to continue with the relationship for next 3 - 4 days. She also suggested to take the Dubagest - 200 twice a day for 5 days. I just want to confirm whether I have conceived. Does it means that the eggs ruputred is a confirmed pregnancy. It is mentioned in a report that RO - 1) Ruptured & 2) 11mm. LO 1) 14 mm. Request you to please call me or mail me. [/INST] see rupturing of follicle doesn't confirm pregnancy..after 14 days of rupturing of egg...wen u do upt test..if u get two lines..it is positive...rupture of follicle means ovulation has occurred. ..after that keep relationship...den after 14 days of ovulation...do your urine pregnancy test </s>

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

<s>[INST] I have shingles... Could that be what is causing my feet to hurt when I stand and walk sometimes? I have had corns on the pads of my feet, but not any of the shingles rash. And it is the pads and heels that hurt really bad when I stand up and sometimes when I m sitting or sleeping! And I have other parts that hurt sometimes for no apparent reason! Like under my left arm and breast. But none of the pain is all the time... But several times a day. [/INST] HI, thanks for using healthcare magicShingles would normally cause pain in a specific region only. It would not cause pain in a number of different areas.Shingles is one of many different causes of nerve related pain, which seems to be the pain that you are experiencing.Other causes include: (1)diabetes(2)low vitamin b12 or folate(3)thyroid disease(4)side effect of medication(5)liver or kidney disease(6)abnormal levels of vitamin b6(7)exposure to toxinsIn some cases, the cause is not found.It may be best to see your doctor if the pain continues. A physical assessment along with investigations are needed.There are medications that can help with nerve painI hope this helps </s>

<s>[INST] HI, I went to get on a rocking chair to water my plant and the rocker moved, i went to catch myself from falling on my face, my arm went way way forward and stretched the crap out of, hurt like hell, and is now hot pink with a side of purple, different shades and swollen i did not go to the doctor yet it happened on tuesday 2 days ago [/INST] hi.noted history of swollen arm and trauma. it is best if you consult with a doctor, preferably an orthopedic or a general surgeon, for physical examination and clinical evaluation, especially if the swelling and pain are persistent. if it's just an inflammatory reaction, the swelling will eventually subside in a few days time. fractures must also be ruled-out. diagnostics, such as xray, will be requested for further investigation. management (medical and/or surgical if indications are found) will be directed accordingly. cold compress and pain relievers may help alleviate the symptoms for now.hope this helps.good day!!~dr.kaye </s>

<s>[INST] I have had a dry cough since I had smoke inhalation from a smoldering fuse box (no fire) back in March of 2012. I was diagnosed with Bronchitis and given an inhaler. I still have the cough, wheezing, tightness but I also had a scope done on my Larynx back in 2011 and I'm a prime candidate for Cancer as the one side is extremely enlarged. My main question is (which I can locate online) what kind of cough is associated with Larynx Cancer? Yes I do smoke but have never had a cough until I had the smoke inhalation. Any explanation of what kind of cough is associated with my previous question would be greatly appreciated. However, if it's not that then the other question would be, how long does it take for smoke inhalation to clear the lungs? I'm having difficulty sleeping as I wake up every 2-4 hours with this dreaded cough. [/INST] hello dearthanks for query at HCMsymptoms in larynx cancer depends up on area of the larynx involved .larynx divided in to three parts supra glottic, glottic and sub glottic, symptoms vary according to area involved .supra glottic: often silent, hoarsness of voice is late symptom. throat pain, dysphagia and ear pain are common symptoms.glottic : hoarsness of voice is early symptom, also produce stridor.sub glottic cancer: earliest symptom is stridor, hoarseness is late feature.nature of cough may not determine the location.smoke inhalation may take years to clear from lungs and it also has long term complication and adverse side effects.cough during sleep and awakening in your case might be due to bronchitis.your diagnosed with bronchitis so all symptoms might be related to it.if you still have strong suspicion of cancer visit doctor get alrynx examined and radilogical investigation like x ray and ct scan might be helpful in your case.regards </s>

<s>[INST] Hi doctor, My child is 15 months old. He is not standing well. He does crawl and pulls up his knees. When I try to stand him up, he is reluctant and seems to be scared and cries when standing. I am worried. Should I be concerned? Do I need to check his hips? Had appointments with a doctor and he never identified any physiological problems. [/INST] Hi. Most babies take their first steps by their first birthday. Most toddlers have walking unaided, often with uneven steps. Do not worry, if your baby takes a little longer time. Some children do not walk until they are 17 months or 18 months old. You should stimulate the child to get them walking regularly. It will help. You should get the child clinically examined by a Pediatrician. CNS (central nervous system) examination is required to be done to rule out any pathological cause. Visit a Pediatrician for a clinical evaluation. For more information consult a paediatrician online --> </s>

<s>[INST] i cant put my finger on it but I keep breathing and smelling a smell of emissons like from a car it has been going on for a while I got my car checked nothing wrong I checked my house for anything nothing my feet itch at the bottom a lot and they are not dry my doctor said I had high level In my liver number 46 and it should be 36 I take norvac for blood pressure 2.5 and that's it I've been primarily healthy otherwise very active I started juicing and I don't understand what this smell is I keep breathing it comes and goes I don't know if maybe I am allergic to something [/INST] Hi, thank you for posting.After I read very carefully I understood very well your concerns. I think that many of your symptoms are related with Norvac side effects, like skin allergy. But this doesn't solve all your problem. In fact your problem is related with liver, I think you suffer from Liver Cirrhosis. The bad smell you are smelling is caused by this disease.You need to make the following tests: 1.Liver function tests ( LFTs or LFs ), liver transaminases AST/ALT/SGOT/SGPT and bilirubin level. 2.Ultrasound of abdomen. 3.Endoscopy (Gastroscopy). 4.CT scan.You should contact your hepatologist.I wish you a fast recover. </s>

<s>[INST] hi doctor, i have two daughter,two of them have labial adhesion,,they suffer from this problem,my third daughter two month diagnosed as Down Syndrome my first question what is the treatment of labial adhesion and the second question is there any genetic link probability between two [/INST] Wash genital organs more often , dry, put between fatty cream with cotton ball and do massage between labia after separation of labia,it can be candidosis, some kind of fungal infection. You can take bacteriological analysis from genital organs at gynecologist and see what kind of infection. Also we see adhesion when mother and their kids suffer from Myc.trachomatis and Chl.trachomatis,but it can be excluded by blood test for IgM,G for this infection.You can apply usual Jonson cream with rolling massage for labia under diapers every day. Connection between daughters can be genetical, but may be they don't Wash genital organs properly 2 times daily with usual waterBest regards </s>

<s>[INST] Hi my brother in law is being investigated for stage 3 ckd. they are testing his urine for egfr and psa/acs. He stated that his blood pressure was within normal limits . The doctor only tested his blood initially due to him having chest pain. What could be the cause of this [/INST] Hello,Most common cause of chest pain renal problem in patients is due to pleural effusion. My advice is to take him for a chest x-ray immediately.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Siva Kumar Reddy </s>

<s>[INST] wheather ozone discotemy is best treatment for disc degeneration disease ? i am suffering from severe back and radiating pain which coming from my left buttock to foot . 6 mnths before i take mri scan , results shows L5 S1 disc degenerative disease . with advice of ortho dr i take bed rest , traction ,pyisotheraphy , still nw i am feeling same . dr adviced me for surgey but i am not prefer surgey . recently i heard that ozone discotemy how is it. wheather it is economy . how many % result is there. in india how many places are there . which is the best one sajeesh kerala [/INST] Welcome to HCM. Still you have pain with all routine management than go for ozon therapy it will definately help you.better you consult good orthopaedician </s>

<s>[INST] Hello. My father is 70 and suffers with dementia. It's been progressive,; he also has prostate problems, takes very little solid food, and is fed mainly by a peg. My mother said that they noticed "dirt" in his urine. He's very weak and is having diarrhoea for the past 2 weeks. Any idea of what the particles in the urine may be a sign of? Thanks very much. [/INST] Hi, It can be albumin clots - he may be suffering from urinary tract infection. Doing a urine culture can help diagnose it. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. S. R. Raveendran, Sexologist </s>

<s>[INST] I am a practising Doctor since 1970.I get patients with pus in semen on Semen analysis and full of debris under Microscope.Urine R/e Doesnot show pus cells 6-8 only.KFT normal,Harmones with in normal limits, no fever or burning. no irritation.Please let me know what can be source osexcessive pus cells in semen. [/INST] HelloThanks for query.Presence of pus cells in semen is suggestive of infection either Seminal vesicle or Prostate .Get semen culture done to confirm the diagnosis .He needs to take antibiotics like Doxicycline twice daily for one month.Dr.Patil. </s>

<s>[INST] My 10 year old daughter, 90 pounds has a bad case of strep and was given 400mg/5ml amoxicillin. The prescription was written for her to take 1ml/2x a day. The doctor refuses to change the script, but pharmacist says this is too little a dosage - she should be on at least 875mg/day. I m confused? Who is right? [/INST] Thank you for asking query.As per weight of the child daily dose of 800-1200 mg would suffice.It could be a typing mistake or doctor doesnt know dosage.Hope this is helpful to you.Rate the answer if you like it.Regards,Dr rushikesh kute </s>

<s>[INST] I am suffering from a very fast decay in my teeth, I want to many dentists but the problem is in my teeth not the doctors, what they can do with such decay in all my teeth. All my teeth has a decay from its starting point, I don t eat a lot of sugar, just drink a lot of coffee, non smoker. The problem that I am getting afraid now a days from washing my teeth, because I feel that the brush will take from them :) What I want to know, how to stop this fast decay fast, I don t want to repair the current decay, I just want to stop it. What to drink, is there any medicines for that? What steps I should do and how fast these steps and stuff I will take will take effect and let me feel that I am better. I am 30 years old, have no other problems in health. [/INST] Hi,Amrelgathy, Thanks for query, First you have to diagnose your problem. Whether you got pyorrhea or dental caries. There may be heavy tartered teeth causing problem. Now a days dental science developed very fast and at the age of 70 you might have all teeth working. So consult dentist and get your problem evaluated and get the treatment done. ok and bye. </s>

<s>[INST] I have severe pain in my legs, knees, hands and arms. My legs, feet, breast and hands swell so badly that I can see fluid pockets and my legs and feet begin to look deformed. The pain gets so bad that I cannot walk up stairs with the pain being worse at night. My chest gets tight and I get out of breath easily. I do not understand what is happening to me. I have suffered from anxiety disorder for 19 years and this is not anxiety. It has been 9 months and getting worse as daily activities become harder. My muscles in my hands are becoming weak and having trouble even opening a bottle. My legs turn a bluish color. I have tried Motrin up to 800 mg and Tylenol. I even bought compression gloves and socks with no relief. In addition, my vision gets blurry and sometimes experience dizzy spells. I do not drink or smoke. 44 yrs old and was healthy until this started. I m so confused and need help for what I should do. [/INST] Hi, Most probably it can be a simple musculoskeletal pain. As a first line management you can try analgesics like Tramadol or Aceclofenac for pain relief. If symptoms persist you can consult an orthopedician and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician </s>

<s>[INST] I have been noticing changes in my testicles the left scrotum hangs lower than right sometimes saggy scrotal skin I have no pain recently seen a doctor no sighn of hernia or infection or torsion if she elimnated all of those why do I still feel uncomfortable and I usually get a fast errction but now it seems difficult to accomplish please help I am very worried [/INST] HelloYou have normal findings.Left testis normally hangs lower than right testis.It is normally found in every male.Scrotal skin appears also changes with changing conditions and emotions.I presume that you have been properly examined by a clinician.It is good that there is no sign of infection or hernia.If your doubt persists then you can go for ultrasound of scrotum.Ultrasound can detect abnormality.Take CareDr.Indu Bhushan </s>

<s>[INST] Hi dr... usually i get mensus between my 28th day to 32nd day.usually i get some cramp in my lower stomach before 10days from my period.this time also i got that cramp.but nw my period exceeds 4days..now 34th day.but now too am getting that cramping occasionally. some white discharge also there. light pain in my nipple. but am not having any other syptoms.am i pregnant?.. i havent take any test. [/INST] Get urine pregnancy test done. These cramps do not necessarily mean that you are pregnant. So, don't worry. </s>

<s>[INST] Hello doctor, My wife is 13 weeks pregnant. Though she takes Doxinate tablet once a day, she still has vomiting. Also, she often gets a stomach pain which eases in five minutes. We have discussed with the gynecologist about these issues and he had suggested a full abdominal ultrasound. In the ultrasound, they found a small sludge in her gall bladder. So, the gynecologist had suggested we consult a surgeon. The surgeon recommended a surgery. If not done, he says the mother, as well as the baby, are at risk. My wife is very depressed after hearing this. He has prescribed Rablet-D and Ursodiol for 10 days. Another issue that she faced is that in the last three days, she felt a mild pain in the lower abdomen. This pain also eases by itself in 30 to 40 minutes. Though we missed discussing this with the gynecologist, the USG report shows that everything is normal. I have attached herewith the latest USG, and blood test reports. Please guide us. [/INST] Hello. I have gone through the reports (attachment removed to protect patient identity). It is good that you have consulted a surgeon and arrived at a diagnosis. It is nothing to panic about. If there are any further doubts you can always consult me. For more information consult an obstetrician and gynaecologist online --> </s>

<s>[INST] I just had kidney stone surgery and they did not locate the stone. They believe I passed it prior to the surgery. I have had this same surgery two other times with no side effects. This time I am in extreme pain and it has been 4 days. My doctor said it is normal, however I have never felt like this in the past. I still have pain in my back and abdomen . Any suggestions as to why I feel like this? [/INST] Hi Welcome to HCM. This passed out stone is quite possible and i encountered this two times in the past month. If a stent has been placed there should be no pain due to the stone as such. But, there may be other reasons for the pain and you need to be evaluated appropriately by the urologist and the general surgeon as well. Best regards DR GS </s>

<s>[INST] My 20 year old daughter is experienced abdominal bloating, cramping and pain coupled with forearm pain which she describes as feeling like she has had an IV in both arms. It begins in the elbow crease and radiates to the wrist. Any ideas? Many thanks [/INST] Hi.Thanks for your query.Noted the history related to your 20 years old daughter related to the abdominal bloating, cramping and pains; also has pain in the forearms beginning in the elbow crease and radiates to the wrists .Both the problems may be unrelated. The abdominal complaints can be due to intestinal obstruction or infection. Get X-ray of the abdomen in the standing position, ultrasonography, stool and blood tests and get treated. The pain in the forearm as you have mentioned can be due to muscle compartment syndrome, thyroid problems, nerve problems and needs clinical examination and investigations accordingly. </s>

<s>[INST] i am working in the meat production company what is the normal count of salmonella(staph O and staph H) that my employees should have for me to allow them into the production while on treatment and what is the dangerous count that should not be allowed into the production? [/INST] Thanks for your query at HCM!I am Infectious Disease Specialist! I went through your query!Dear Salmonella and Staph are two different organisms.Normally the titres depend upon the edemic titres of every region.But "O titres"> 1:100 and "H titres " > 1: 200 are considered diagnostic.The person after treatment is not a threat.But chronic carriers must be tested by stool examination for salmonella infection.Happy to take more queries! You can also write a review for me. If you would like some more information, I will be happy to provide. You can take a follow-up query.Take care!Dr. Sheetal VermaInfectious Disease Specialist </s>

<s>[INST] What s wrong with my mouth and tongue ? I have excess mucus. Feeling like I have to constantly swallow or clear my throat. The roof of my mouth looks like it s bruised and yellow in the back of my throat has red splotchy Kinda look to it but it s not painful. And then my tongue was white coated and all that stuff is scraping off and now I can feel my taste buds because my tongue is bumpy and it hurts to eat. I am a smoker, and I brush my teeth morning and night and floss everyday.. I m hydrated my urine is almost clear. [/INST] Hi..Thanks for the query..Your symptoms are clearly pointing towards fungal infection in mouth and the white coating is due to yeast/fungal growth over the tongue..The condition is known as Oral Thrush.The inflammation over the roof of the mouth is also due to infection..As you are a smoker, thrush is common and if you continue to smoke it can also worsen the infection..So first of all you should quit smoking.In case if you are addicted you can go for nictotine replacement therapy in the form of nicotine patches and gums..Fir thrush you can gargle with specialised mouthwash like Nystatin mouthwash that is an antifungal composition..Suck Clotrimazole lozenges.You can also be advised oral antifungal medicines like Flucomazole..Drink plenty of water..Clean your tongue daily with a tongue cleaner.Eat plenty of probiotics like Yogurt and garlic as they are helpful and clearing infection faster..Hope this helps..Regards. </s>

<s>[INST] Hello, Im 51yrs.old and I have been have muscle cramps all over my body now for 5days...Went to hospital and got Fluids w an IV ,but at that time it was only my legs...then later that day I started have cramps in arms, jaw, upper lip and need some ideas what to do please... [/INST] Hello, I have studied your case. Cramps in the whole body are usually due to lack of sodium and calcium in the body. So you need to check if your calcium and sodium are normal. If you are on high blood pressure medicines then chances of salt deficiency are higher. So go through this test. You can also take salt with juices and water. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Naveen Kumar Sharma, Orthopaedic Surgeon, Joint Replacement </s>

<s>[INST] Hi, I am 28 years old. I have a slip disk in my lower back. It hurts me a lot. Sometimes it is very difficult to even walk I used to practice Yoga a few years ago. But off late got lazy/busy and not practicing yoga now. I am putting around 14-16 hours infront of computer per day. And my situation is worsening. I need to get rid of this pain. What do you suggest I must do? [/INST] Hello,I read carefully your query and understand your concern. The symptoms seem to be related to a herniated disk. I suggest to use anti inflammatory medications such as Ibuprofen to relieve the pain. I also suggest physical therapy and gentle stretching exercises. If the pain continues, you should consult a neurologist for further evaluation. Hope my answer was helpful.If you have further queries feel free to contact me again.Kind regards! Dr.Dorina Gurabardhi General &Family Physician </s>

<s>[INST] I have been taking Allegra for about 5 days. I feel short of breath at times and back and chest discomfort at times. the only prescriptions I take are protonix and felopodtine daily.I have allergies most of the time,but right now BAD.runny nose ,itchy eyes and nose running constatly.This time of year is bad with trees and leaves and wind.Live in the northeast.This the first time I take allegra. I have hypertension. rapid heart beat at times. [/INST] you need to cure allergyany allergy can develop at any time at any age with any substanceit can be pescription medicines for other ailmentsoils shampoo creams ointments and body application materialsit can be food pollensget tested your blood serum for allergens consulting the allergy doctor and treat itfor time can continue antiallergic bronchodilater syp antacid sypneosporin h ointment in nose bd sea water 2 drop at night each nosethis can help you </s>

<s>[INST] I have been experiencing swelling in my right leg, especially around my ankle, the back of my leg is sore. How do blood clots feel and look if this is problem with the soreness on back of leg? I am on meds for hypertension, have a pacemaker defifib, and told recently have kidney damage. I am waiting on doc apt for results from an Ultra sound for kidneys, in mean time my cardio took me off my water pill, and Lisinopril 40mg because of finding the kidney damage. [/INST] Hello, I have studied your case.Your symptoms suggest possibility of Deep vein thrombosis.Ultrasonography/colour Doppler leg will help to rule pathology leading to pain and swelling like deep vein thrombosis. I will advise you to do repeat MRI spine to see for any nerve compression.Consulting your doctor infection can be ruled out; antibiotic can be started according to examination.If required you may need to do blood investigation for prognosis and recovery.I will advise to check your vit B12 and vit D3 level.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care. </s>

<s>[INST] For the past couple of days, the foreskin, including just under the tip of my penis and the shaft foreskin has been quite dry, flaky/peeling, and even leaves little cuts due to common erections. The foreskin is mildly wrinkly, as if lacking moisture, slightly red, but otherwise has its normal color. I am not sexually active, and I take showers everyday and wash thoroughly. Could this be dry skin, or signs of something worst? Lastly, what medications should I take to stop the dry skin, protect the cuts, and end the flaking/peeling? Thank you for your time. [/INST] Hi, Very difficult to comment without seeing directly or pictures. You need to make sure that you are not diabetic. Get a direct check-up. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr B. Radhakrishnan. Nair, OBGYN </s>

<s>[INST] I am 36 years old men. Since 2002, I am suffering from Fatty liver probelm. In 2007, I underwent the GI Endoscopy and diagonised the H Pylori infection. I have taken the necessary medication for the same. Since last two year I am also suffering form High BP, High Cholestrol and now this week also diagonised with starting Diabetic Glycosylated Hemoglobin 7.3 Glucose 113 mg/dl Total Cholesterol 312 Triglycerides 244 HDL 45 LDL 204 VLDL 63 HDLC Ratio 6.9 SGOT 33 SGPT 61 Blood Urea 26 Serum Creatinine 1.00 Vitamin B12 241 My current ultra sound report shows normal report but with Focal hypoechoic area of size 20X14X17 mm is seen in left lobe of liver. Liver is normal in size (13.4cm) amd shows increaed echogenicity. I am suffering Hypertension, body fatigue, and body pain. No freshness in body. [/INST] Hello, Your reports suggest dyslipidemia with pre diabetes ( if sugar level of 113 is fasting value ) and low levels of VIT B12. Body fatigue could be because of these problem or may be associated hypothyroidism ( get your thyroid also evaluated ) . You should start taking medications and do the following... Calorie reduction and reduction of weight.( be in your range of BMI ) Regular exercises Avoiding sweets,deep fried fatty foods,transfats,junk foods like pizzas and burgers and avoid colas. Consume more of fresh fruits and green vegetables. Get few injections of VIT B 12 as advised by your doctor. Your cholesterol,high liver enzymes and fatty liver shall be all right in 4 to 6 months time. Quit smoking,if any. Target of your LDL should be below 80 Target of your triglycerides should be below 150 BP should be below 120/80. Keep your fasting blood sugar below 90 Thanks </s>

<s>[INST] Hi, I got my arms and legs waxed and the next day I had an allergy on my arms. I am not to sure if this allergy is due to the waxing or cuz of the woolen jacket which I wore on d same day....? Any recommendations I am allergic to betnovate ointment..... Is it alrite to use tenovate-m [/INST] Hello Khangura, It is most likely secondary to procedure and you must ensure you get a patch test to exclude chemical sensitivities. I presume the 'allergy' was also on the legs. If you had a similar reaction to waxing before, then it is even more important to exclude the chemical sensitivities before you go through another waxing procedure. Allergies to steroid creams are possible and this can also be checked when you have the patch test. For the time being, antihistamine tablets such as cetirizine 10mg twice daily or allegra 180mg once daily with Calamine lotion on arms and legs should be enough to control the reaction. I hope this was useful. </s>

<s>[INST] I am facing issue of skin rashes since the past 4-5 years. I get itching on my body, especially back of the shoulder, hands, thighs; and wherever I itch, that place on the skin becomes red and gets a bit swollen. To overcome the same, I have to take Levocetrizine tablets every 3-4 days. The frequency of taking the tablet varies depending on the season(less tablets in winter, more in summer). I have tried allopathic, homeopathic and ayurvedic medicines for permanent treatment of the same, but to no avail. Once I visited a homeopathic clinic for a free consultation for hairfall, and they detected "Seborrheic Dermatitis", however I did not go ahead with any treatment, hence not sure whether that is actually the case or not. Age: 28 Sex: Male Other problems: Allergic rhinitis since a long time, sensitive skin & lowoverall immunity. Residence: Vadodara, GUJARAT, INDIA [/INST] Hi, Thanks for using HCM.Your history suggest you are suffering from allergic rhinitis(AR) and dermatitis. Avoid allergens, Can continue wit levocetrizine every night one tab and apply topical steroid for the lesion that will help you. For AR can take mometasone nasal spray. If severe wit AD, then can get done skin prick test to find the allergen and immunotherapy can be given for complete management which cover for both AR and AD. Have proper sleep, plenty of fluids, nutritious diet with required calorie and regular outdoor exercises for your wellbeing. Hope I answered your question. Consult your doctor for further examination and management.Feel free to ask me if you have any further queries.Wish you good health. Take care.RegardsDr.Lohit </s>

<s>[INST] My Ct scan showed that I have some component of fatty infiltration of the liver. Mild hepatomegaly. My liver measures 22 cm. No space-occupying mass in the liver or the spleen. No abnormality in the pancreatic bed. The gallbladder appears normal. Adrenal glands appear normal. There is no renal mass. No hydronephrosis of the kidneys. There is no aneurysm of the abdoninal aorta. No enlarged adenopathy. No free fluid within the abdomen. There is no indujration in the nesentery. Mild Hepatomegaly. Dinfiltration of the liver. Otherwise, negative comuterized tomography of the abdomen. I used to drink whiskey when I got upset or depressed about something, but quit just recently, and I don't want to drink any kind of alcohol ever again. What does this medical report that is written about my Ct scan mean? Also my blood work came back that I have good liver function, kidneys, and etc. Does this mean I have some kind of liver damage in areas of my liver? Since I don't drink anymore will my liver get better? What can I do or take to help my liver and entire body get back in shape and back to being healthier again? Thank-you for your medical advise, please write me back soon. YYYY@YYYY [/INST] Hi, many thanks for the query!Well, your report is not that bad to be worried so much, but the decision not to drink anymore, is perfectly correct & all that is needed.You should start some medicines for reducing fatty infiltration of your Liver with your doctor's opinion.Rest all findings in your report are normal, also its good that your Liver function tests are normal.Do regular exercise, also yoga & meditation if possible.Wish you a good health.Take care.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] I am making an inquiry for my daughter, who has suffered over 20 years with severe pain, unable to work, hyper sensitivity to light, touching fabrics, migraines, noise, emotions, inability to function on disability, but no help. Thinking about Allergic to Life, read in Discover Magazine would like to see a professional who could possible help her, diagnosing this allergy to chemicals and it's symptoms. She needs help desperately as I do, she is now in her mid fifties with no hope for any kind of future. Would like an appointment with a doctor proficient in this category. I am her mother. [/INST] HIThank for asking to HCM I really appreciate your concern for you daughter, Mam we are here to help the patients, this forum is mainly to advise the patients with the best of our knowledge we did not provide any information for any specialist or for any particular doctor like yellow page work, now for your daughter there must be some aggravating or triggering factors which could be responsible for this kind of reactions this may be called auto immune disorders, and this always goes away unnoticed your daughter need to keep her stress level very low, no need to worry she will be fine with the time give her strong moral support have a great day. </s>

<s>[INST] when i get up, before and after i eat and throughout the day my stomach has severe pains it feels like hunger pains but its not because it does this after i eat to and then i go to the bathroom and there is alot of blood in the toilet and throughout my bowel movements what could this be? [/INST] Hi.The blood throughout he the bowel movement and the history you have noted , this can be due to ulcerative colitis or IBS with severe colitis. I would recommend you to undergo colonoscopy to see the reason, get a biopsy done and institute appropriate treatment.Get stared on an antibiotic, probiotics, metronidazole and supportive treatment. Get investigated : blood, urine and stool tests, ultrasonography, colonoscopy. </s>

<s>[INST] hi i hit my husbands hand with mine playing around and it has been swollen for four days. it has a knot ontop of my hand and is sore. my fingers are badly bruised. it instanly swole up when it happened. do u think its broken should i get an xray? it doesnt hurt to move it just when i touch it. [/INST] Hello, As you had the injury while hitting, and no pain while movements then it won't be a facture. I don't think any kind of x-ray is needed for now. Do icing to reduce the pain and swelling twice a day. In between do hot water fermentation and move your fingers within the hot water tub. After a week or so you can try pressing the sponge ball slowly to regain the strength. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist </s>

<s>[INST] Hello, i have reoccurring small dots like the end of a biro on my right foot only. They come ovr a week or 10 days, become itchy and when itched fill with fluid like a blister. i have them aroung the heel and down the right side of the foot and between my big toe. after they have been itched and ooze they scab over and them the skin is normal a few days after. they reappear every few months [/INST] Thanks for your query at HCM!It seems you have some sought of fungal infection (dermatophytic). I suggest you get your fasting and random sugar get tested. You must collect the fluid by pucturing of blister and send for tests like gram staining, microscopy for fungal elements, culture- aerobic/anaerobic bacterial and fungal tests. Follow up with investgations for proper treatment. In meanwhile after sampling you can apply some triple action cream.Take care! </s>

<s>[INST] hi my aunt is to undergo valve replacement surgery, she has tooth cavity but the dental doctor checked it out and said that it would not be an issue as it is not giving any kind of problem to her at present! thought of having a second opinion but due to time constraint ended up in searching net... whats ur say on this... expecting ur valuable and a educative reply at once [/INST] Hello,Thanks for consulting HCM, Read your query, as your aunt has to undergo valve replacement and she has cavity dont worry if she doesnot have pain in cavity tooth you can go through surgery if she had pain in carious tooth then you should consult dentist and go for its treatment . I will advise you that after surgery when she is fine then consult dentist and go for treatment of tooth.Hope this will help you. Wishing you good health.Regards, Dr. Priyanka tiwari </s>

<s>[INST] My boyfriend and I were outside earlier and I m not sure if something bit him or something stabbed him, but something happened&There is a bump thing on the top of his foot and he is having severe pain and swelling around it. Any ideas of what it might be or what might help? [/INST] Hi...thanks for sharing your problem here in this forum...I can understand your problem...your boyfriend got swelling with readness and pain on the foot...if it was abruptly enlarged and there is some sting mark this must be a bite by something ...i will advise to see the doctor...you can give him some antiallergic for time being..but he shoulg get tatnus immunization if its trauma or bite...hope you got your answer...thanksDr ihsan </s>

<s>[INST] I have coronary heart disease for many years and have been on statins all that time. Recently my PCP took me off the statins, and now after three months I am having chest, left arm pain. Can being off the statins be enough time for the cholesterol deposits to increase enough to cause this pain? [/INST] your pain is not because you stopped statins.but it's definitely an important symptom for you to visit your cardiologist and get a check up done.get a ECG done and see if there are any new changes in that as compare to previous one.you might need to go for a TMT as well. Don't ignore your symptoms,specially when already have coronary artery disease. </s>

<s>[INST] hello, im a 18yr old girl and have had blood tests 2 yrs ago saying i had low iron. i took vitamins for a little while. then stopped. I went on a no redmeat diet a few months ago and started getting mouth ulcers. i looked it up and saw low iron is a cause so i stopped. i often get dizzy spells, random nosebleeds. I fall asleep in class even when i get a good nights sleep. is it possible i could be anemic? [/INST] Hello and welcome to HCM, Inoredr to assess whether you have anemia or not, you need to get certain investigations done- red blood cell counts, hemoglobin, red cell indices and peripheral blood smears examination to know the degree of anemia and type of anemia. Once the type of anemia is known, the cause of anemia can be assessed and thus treatment can be planned. Mouth ulcers usually occur due to deficiency of vitamin B group. Dizziness is a non-specific symptoms and can occur due to a number of causes. Thanks and take care Dr shailja P Wahal </s>

<s>[INST] dear doctor,i have very swollen, red tonsils that are now COVERED in white spots which are now turning yellowish and some grayish-brown. i went to the doctor and they performed the swab and told me it wasnt bacterial so its viral. i know when it comes to viruses your body just needs to stay hydrated and fight it off. my issue is that in the last 5 months ive had painful tonsilitis at least 6 times. I feel my tonsils are doing more harm than good for me, should i get them removed? also what are the best home remedies for this? [/INST] Hello, Welcome to HCM.I understand your concern.As a home remedy for tonsillitis, you should do gargles with warm salt water or with chlorhexidine & water in 1:3 dilution. They will not treat the viral infection but prevent super-added bacterial infection. You can also take lozenges available OTC. Also take plenty of water and warm liquids. Take paracetamol with ibuprofen for pain relief, fever and inflammation.You can get your tonsils removed if you have recurrent tonsillitis. You have said that you had this problem 6 times in 5 months. Guidelines about tonsillectomy says that it can be done if tonsillitis occurs 7 times or more in a year or 5 times or more per year for 2 years consecutively or 3 times or more per year for 3 years consecutively. So, see whether you fall in these criteria or not. Tonsillectomy can also be done if tonsillitis is severe and affecting day to day life. Consult a good ENT surgeon for the same and decide further.Hope this will be helpful.Do ask if any more question.Thanks for using HCM. Take care. </s>

<s>[INST] Please i would like to get some information, i was in the hospital and i got diagnosis that i have cholesterol gallstoneы (2 stones) the doctor said me that i had to delite this gallbladder.. please maybe can i have any way of treatment? some medicines or? [/INST] HelloWelcome to HCM.Thanks for posting your query.I understand your concerns.As you are diagnosed with gallbladder stones,definitive treatment for this is surgical intervention that is removal of gallbladder called cholecystectomy.If you opt for non-surgical line of management,it will be a temporary relief.Thank you </s>

<s>[INST] my daughter has a recurring cyst on her buttox she is 2 1/2 now the doctors tell us its staff infection an give us antibiotic an a cream it goes away for a while then keeps returning 4 times in the last 8 months she drinks a lot of milk an eats a lot of dairy could this some how be effecting this if not what should I do I ve disinfected our home an we have all been taking bleach baths directed by the doctor [/INST] Hi Dear,Welcome to HCM.Understanding your concern. As per your query you have recurring cyst in the buttock. Well there can be many reasons for symptoms you mention in query like bacteria or fungus located on the surface of the skin can cause a boil. Boils are quite common and are usually caused by the bacteria Staphylococcus aureus, the most common bacteria found on the skin. When the hair follicle is damaged by a scratch or other break in the skin, the bacteria is able to move deeper into the follicular tissues, causing an infection and resulting in a boil . If cyst is appearing again and again then there must be other underlying problem like low immunity and diabetic condition . I would suggest you to consult dermatologist for proper examination . Doctor may prescribe antibacterial like cephalexin , clindamycin or erythromycin , anti fungal like fluconazole or vitamin supplement to boost immunity . For now apply warm compresses and eat healthy diet . Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari </s>

<s>[INST] HI my daughter is 9 months old and recently she is sweating alot while sleeping at night. the room temperature is fine. She sleeps right through although i am now having to change her nappy through the night due to leaking so im guessing she is urinating more than normal? [/INST] Hi.... excessive sweating with normal temperature could be due to day autonomic nervous system disturbance. This could be a predecessor for wheezing also. I suggest you get in touch with your pediatrician regarding this.Regards - Dr.Sumanth </s>

<s>[INST] i feel dizzy and ill, my ears are hurting. I have been under some stress, just sold my home, my mum has not been well, lost my brother 4 months ago to cancer and my father 4 years to cancer. I have been having some anxity issue and panic attacks in the last few months. [/INST] HIThank for asking to HCMI can understand your problem, I am really sorry for that , but loosing moral because of undue circumstances is not wise the anxiety and depression could cause more problem right now you have to find the ways that could ease your tension but you are inviting to such things that could increase your problem for sure, taking medicine in this situation again not good idea because drug could stops your thinking area, better to brig back your confidence, think in positive way, form a strategy for further life, hope this information helps you take care and have good luck. </s>

<s>[INST] My daughter saw a dentist today and she has a tooth that wasn t hurting but needs either extraction or root canal treatment, but she is now in agony as the tooth has started really hurting. The dentist said there may be an abscess there but that she didn t need antibiotics at this stage as there was no pain or swelling. I have flucloxacillin in the house, should I give her some until she can get an appointment? [/INST] Hi Dear,Welcome to HCM.Understanding your concern. As per your query you have symptoms of toothache which seems to be due to systemic infection which could be due to badly carious tooth and formation of abscess in that area.Need not to worry. I would suggest you to consult dentist once and get IOPA( X-RAY) done to check extent of infection as there could be chances of bone involvement is there. Go for extraction of tooth and any surgical procedure/restorative procedure if required. Yes you should take Fluoxacillin to avoid any infection. You should do warm saline gargles on daily basis and maintain proper of oral cavity. Avoid intake of sharp and sticky substances. Take proper course of Ibuprofen and Diclofenac.Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari </s>