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<s>[INST] My grandson when he was born had a small opening on top of his nose. The doctor said it was a tract that didnt completely develop. He's now 18 months old and has developed an infection and the bridge of his nose is swollen and at the hospital getting an iv of antibiotics. what is this tract? [/INST] For an infection and swelling of nose you can give your grandson some antibiotic preferably syrup moxikind-cv or syrupzifi-cv after an expert advice along with syrup ibugesic-plus or syrup brufen junior for pain and swelling. Do hot water fomentation over the local site. </s>

<s>[INST] My name is augustina I ve had a surgery for lump in my left breast which the doctor says is Fibroid Dyplesia 25years ago over the years a lump has grown on my back on the same left side the lump is not painful but in my body under the lump is paining a lot sometimes I cannot move my arm Can it be breast cancer or can the lump be operated on [/INST] HI,Welcome to HCM with your query.Confirm the diagnosis before the Treatment Planning-By the facts of your query,In my opinion,you seem to have infective lump?Boil/Sebaceous Cyst with reactivated infection in it,as its paining under the lump.In such a situation,its very difficult to confirm its relation to the Fibrous Dysplasia removed 25 years back.But the chances are there of link to the Fibrous Dysplasia,as this lump in the back on left side could be a Secondary metastasis from a occult/hidden breast cancer in the left breast.Treatment-Antibiotics/anti-inflammatory treatment from your doctor, if responded would confirm the infective cause of it.Non response would need Second opinion from Surgeon who would direct further treatment after proper examination and investigations,accordingly.But don't worry till this lump in the back is confirmed by biopsy as Cancerous and Could be treated by -Surgical Excision with Biospy,which would confirm further treatment line.Hope this would help you to plan treatment with your doctor.Will appreciate hitting thanks and writing review comments to benefit needy patient visitors at HCM like you.Good day.Dr.Savaskar M.N.Senior Surgical Specialist.M.S.Genl-CVTS. </s>

<s>[INST] I have a lump in my stomach right below my ribs! Sometimes when I move or stretch it makes a pop sound and sometimes is also hurts! My dad said that it could be an asise or however its spelled but he won t take me to a doctor to see! Please tell me what it is and if it also could be cancer! My dad said that I ve been looking pale lately also. I don t kow what to think :( [/INST] Hi, Thanks for query, As lump is below the ribs on right side it is likely that you might have enlarge liver. If it is superficial it may be costo chondritis or small lipoma. Consult doctor and get examined. Ok and bye. </s>

<s>[INST] Hi doctor, I am 70 years old. I have intermittent chest pain. For the past three months, I could not walk fast and climb stairs. But, I was doing it before normally. I suffer from shortness of breath with palpation and when the chest pain persist the breathing problem is severe. I underwent ECG and echo test last month, in which the results are normal. In the CBC test, it showed an elevated WBC (21800). I was asked to take an x-ray chest PA view. The result was normal. I have low BP (80/60 mmHg) due to which I got numbness in hands and legs. I was unable to respond back due to dry mouth or tongue with severe chest pain and giddiness last month. I was also asked to take brain MRI and EEG test. The results were normal. The only thing it showed was that I have sinus in MRI report. My general physician prescribed me Inderal 10 mg for palpation, Razo 20 mg, Bifilac, Mont and C-tax O 200 mg. Now, the chest pain started again, and it lasts three days. The pain is like stabbing and as such a rock is kept. Kindly advise me what can I do further. Do I need to take any further checkup for the heart? I was advised for Holter monitoring, which is yet to be done. I am waiting for your reply. Many thanks in advance. [/INST] Hi. I have noted all your details. Your symptoms can be most likely because of congestive cardiac failure. Cardiac failure is not an indicative of a defect in the heart, but it is a situation when the heart pumps weaker than what is deemed as natural. Therefore, the blood flows at a slower rate to the heart and the body that in turn increases pressure in the heart. In an attempt to hold more blood, the heart stretches the chambers. Though this strenuous effort may keep the blood moving, it would gradually and inevitably weary the heart with all the effort. Subsequently, the kidney responds by retaining more salt and fluid in the body. These fluids may accumulate in different parts of the body, mainly in the legs, feet, ankles leading to congestion in the body. This condition in medical terminology is referred to as congestive heart failure. The most common cause of CHF at the age of 70 is coronary artery disease. I would suggest you some of the baseline tests of cardiology to rule out any element of coronary artery disease apart from 2D echocardiography. Stress test as any ischemia to cardiac muscles will be reflected in the stress test. Along with 2D echo, they have a sensitivity rate of more than 85% to rule out coronary artery disease. Other tests advised are as follows: As per your query, the medicines you are on have nothing to do with your symptoms. For further information consult a cardiologist online --> </s>

<s>[INST] I had an initial procedure for root canal. Within the hour, I had pain. I called the dentist and was told that it was due to the infection and once I take the antibiotic for a couple of days, the pain shouldn't persist. I took 600mg of Ibuprofen at 1pm and it relieved the pain. Around 6pm I was in pain and took hydroco apap 5-500 mallinckro at 7:30pm. I am in excruciating pain. Can I take ibuprofen 800mg now (9:30pm)? Also, I called the dentist and left a message concerning the severe pain. [/INST] Hello, Thank you for consulting with HCM.Actually tooth pain is a very severe pain, to get relief from it you have to get the treatment done, either root canal or removal of tooth.Till then you can continue with the same medication or start with a ketorol DT or Dispersible Paracetamol.Hope it will help you. </s>

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

<s>[INST] hi this question is regarding my two and a half year old son,he has just started going to preschool,i am really concerned about him as the teachers have advised us to visist a psycologist,as a child he is extremely bright,very found of learning new things,very fond of people s company,basically an extrovert,cheerfull child ,he wants to do things by himself very fond of electronics ,but there has been a bit of speech delay,he has starting forming sentences but still cannot express himself what he actually wants,since last week he shas started saying things such as im hungry ,give me milk etc,also he is very aggreessive at times,intially he hit his teacher and quiet a few of his classmates but now he does not use force at school,what his teachers are saying is his speech is not similar to other children and another thing he does not take change in activity easily,before going to next activity teacher has to politely explain him 2-3 min in advance ,at home also if he is into something he wo nt listen to us untill he is done with his activity.if he throws tantrum it becomes very difficult to handle him,he is full of energy,at times we cannot match his energy but one think i have noticed he does not like being told no but if we make up a story ,he will believe us immediately and obey us.although he is very aggressive and hits children alot but many atimes it is untentional ,just because he cannot express himslf he uses force,and he is more innocent than his age grop children,he will never complain if other child has hit him or hit him first,many a times some children will just start crying when he is near them and he will get blamed he will never defend himself.he is more brave than other children and also exremely sensitive but does show his emotions easily remains cheerful,is he suffering from some kind of disorder [/INST] this may be a sort of autistic disorder in which child does a fix type of activity with lack of social interaction and delayed speech. it may b associated with tamper tantrum. child may be brilliant in study.u should consult with a pediatric neurologist </s>

<s>[INST] I have a rash that looks like hives that I have had for over a week. Several spots on my neck, some on my arm and some on my leg, a few on my torso. Today I have two white spots on my forehead where I had a shingles outbreak a few months ago. Do I have shingles again? The rash is not painful, but very itchy [/INST] Hi,Thanks for posting your query to HCM.I can understand your concern for the Hives like rash on neck, arm, legs and torso.Shingles outbreak occurs only once in life time and never recurs again. As you had got it once so the possibility of same is unlikely. The present rash can be a part of simple urticaria only. I suggest you to apply medium potency steroid cream application because are best effective in these condition. I would have opted for either mometasone or Fluticasone or cortisone cream. Do not pinch, pop or scratch or een touch the area unnecessarily as it can cause aggravation of the rash. Wear cotton clothes and cotton inner garments which will give a soothing feeling to the skin. Stay away from extreme of environment such heat and humidity.Take care. </s>

<s>[INST] For the last two months I ve been getting pains including - burning pains in upper right chest, sudden and unprovoked heart flutters, tingly arms and jaw, mild shooting pains all over upper body. The first instance was when I running at the gym, and I I first felt pain in upper right chest. [/INST] Hi,Kindly get an ECG done to rule out cardiovascular problems. if you are a smoker please quit smoking. For heart burn please take Tablet pantoprazole 40 mg half an hour before breakfast daily for three weeks. you shall find improvement.Regards </s>

<s>[INST] I fell onto a tiled floor a week ago today, my right knee is cut and bruised but a lump came up almost immediately. it is still there now at the top of my kneecap, my knee is sore and warm to the touch but I can walk without problem. Just feels stiff but I thought it was because of the grazes I sustained to it. Any ideas? [/INST] Hi ! Good evening. I am Dr Shareef answering your query. You might have got a hematoma of the knee (blood collection) due to the trauma. Walking without problem signifies that the joint ligaments and cartilages are possibly not injured. If there is no fresh ooze, the hematoma may gradually subside with absorption, but it would need proper rest and splintage of the joint. In case the problem increases which interferes with your walk, then you might have to see an orthopedic surgeon in your area, who might advise you for an x-ray/MRI of the injured knee joint. Till that you could start taking an anti inflammatory drug. Further management in that case would depend on the MRI report.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. Wishing you an early recovery. Dr Shareef. </s>

<s>[INST] Hi doctor, I have history of periodontitis. It runs in my family. I fixed my top teeth (two bridges of crowns), but not my bottom teeth yet. Last few days it got worse as I have one very wobbly tooth and pain all around my jaw bone. I think it got infected. Can antibiotics help? [/INST] Hi. I suggest you go for full mouth scaling and root planing. After that, follow these: Maintain good oral hygiene, proper cleaning of mouth after every meal and soft massage with fingers. Warm water and salt rinse 5 to 6 times daily. Do not allow food lodgement. Antibiotic, if you wish you can go for Doxycycline 200 mg for one day followed by 100 mg for 14 days. But I would suggest you go for scaling and root planning first of all because infection should be removed. Follow up after three days. </s>

<s>[INST] Hi, I am a 60 year old woman. I had pneamonia last fall and was on Leviquin 500 and Leviquin 750 when the 500 wouldn't work. Then I was on Amoxicillan. Since that time I have gotten underarm Candida. It is driving me nuts aand would like the best aproach to getting rid of it. I have been putting Nystop on it , but it seems to not improve any. I have read so many things like eat fruit and veggies and don't eat fruits and veggies. HELP [/INST] Hello Madam,I understand your concern. I hope that you're not suffering from any underlying cause as you've not mentioned (such as Diabetes). You also have not mentioned the duration and whether the patch is growing or static in size.So, considering your diagnosis is right, I would suggest you to take these precautions and treatment.1. You should keep the area dry constantly and should wear comfortable clothes which doesn't irritate the area or rubs against it.2. You should also take a notice of the size and color of the patch and not whether it is spreading, growing ar changing color.3. Considering the patch you mentioned is candida and you don't have any underlying conditions, I will suggest you to apply a cream with combination of antifugal clotrimazole and a steroid betamethasone.Apply the cream when you're home and take the ablove said precautions.It should help you in 10-15 days depending upon the size and thickness of the patch.If this is not helping you, i would suggest you to visit a qualified physician to make a clinical diagnosis and treatment.Hope this helps.Kind regards. </s>

<s>[INST] Aunt, 92.5 years. Stage 4 Gallbladder Cancer . Mets to the liver. Central portion of liver in disease. 20-25% of liver involved. Unidentified spots in Lungs. Present symptoms: fatigue . painful cough. lessening appetite. some weight loss . What should these next three months look like for her? How fast will entire liver be involved? What happens when liver is extensively diseased? She will decline all but palliative care . Thank you [/INST] Hello It is very difficult to predict about the exact time frame of the survival of the patient as it depends upon not only the physical condition but also the will power of the patient. As such with such extensive metastasis,only 3 to 6 months is the time period of survival. Thanks </s>

<s>[INST] I'm a 20 year old female. I have been getting dizzy spells many times a day for 3 years straight. I fell twice in one day sometime in 2013 my body felt as though it couldn't stand up. Everything goes black and my head feels like it's pulsing extremely fast. I fell today and my mom asked if I fell cause there was a bang I couldn't remember falling but I knew I had. What is going on? Is this serious? [/INST] Hello dear,The symptoms as mentioned in your post can be attributed to pathology in the Vestibular Apparatus in inner ear (it is associated with maintenance of body posture & balance) most probably Labyrinthitis or Benign Paroxysmal Positional Vertigo.Symptomatic relief can be obtained with intake of Vestibular sedatives like Betahistine or Cinnarizine preparations (to be taken only under the guidance of a Physician).If it still persists, then you need to consult your Physician/ ENT Specialist & get a complete clinical examination done.Investigations like estimation of blood pressure, blood sugar levels, serum electrolytes & vestibular function tests will be required to rule out any pathological cause for the symptoms.There is no need to worry, you will be fine.Till then, maintain adequate hydration & proper nutrition status and avoid stress.And also take precautions of getting up from bed slowly & avoid sudden head movements.Wishing you a Good Health.Take care. </s>

<s>[INST] I have been told I have hemocromostis because my ferritin levels are high..my second dr said no...how do I know if I in fact have it..is there a special test I can have to prove it...one dr said it is genetic but want to know how she came to that conclusion [/INST] Hi thanks for contacting health care magic.Noted you have high serum ferritin.Its elevation merely doesn't suggest hemochromatosis....It is acute phase reactant .so can be elevated in various inflammatory or infective condition...So detailed investigation done...Here for confirmation of hemochromatosis HFE gene mutation study can done by PCR or FISH....Hemochromatosis can be acquired also...as well as genetic...Liver biopsy also useful...Hope your concern solved.Take care.Dr.Parth </s>

<s>[INST] My husband says he tore heart muscle from stress but they let him come home from hospital with no medications or instructions as for as I can tell. Does this sound reasonable? Just need to know if I should be worried bout him not taking it serious. If he did is there anything that can be done. Thanks. YYYY@YYYY [/INST] Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. I understand your concern and would explain that a tear in the muscle heart is usually related to coronary artery disease and leads to a serious medical condition. May be it is a stretched muscle in the chest wall. Anyway, I would like to directly review his cardiac ultrasound report and other blood lab tests for a more professional opinion. Hope I have answered your query. Let me know if I can assist you further. </s>

<s>[INST] My son is 22 months and been generally irritable, clingy, tantrums for past couple of weeks now. He has had a cough, now is urinating far more often ie every 20-25 mins, drinking a lot. He vomited yesterday and tonight ge is cold and clammy with very low temp 34.3, help [/INST] Hi...by what you quote I feel that he might be having a urinary tract infection (UTI). I suggest you get a normal urine routine analysis done and see your paediatrician with it. If it is suggestive of UTI, you may need to go ahead with a urine culture and oral antibiotics too.Regards - Dr. Sumanth </s>

<s>[INST] Good afternoon. I woukd like to ask if it is life threatening. My father s sgpt result is 186. He s a harddrinker before and stopped for almost a decade. Then lately he has always a boil(bigger) and healed for almost 2months. Then after a month another boil. [/INST] Hi, An elevated SGPT in itself is not dangerous. It has to be considered with all the other liver enzymes, including bilirubin. I suggest he has these tests taken and possibly an ultrasound of his liver. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Anders Mark Christensen, General Surgeon </s>

<s>[INST] My grandaughter was diagnosed with CDLS at age 3.......she seems now at 27 ro have gotten worse. She is on multiple meds and living in a group home. At a younger age she would write imaginative stories for me. Now, I know she could not do that. My question does CDLS progress (regress) as they age? She also has been diagnosed schizophrenic. Her IQ was 70 but I doult it still is. Thank you Distraught Grandmother [/INST] Hi, CDLS syndrome is rare genetic disorder charachterised by microcephaly , facial phenotype and git disorders.CDLS is known by developmental delay and is progressive. Thanks </s>

<s>[INST] My father is recovering from a severe gallbladder attack resulting in sepsis , etc. Pending his next evaluation, while on antibiotics , he was instructed to be on a NO FAT diet. He has eliminated all meats, oils , & dairy (except non-fat milk). What about plant-based fats such as lentils, rice, beans, etc.? His doctor is on holiday & unavailable for advising. [/INST] Hi and welcome to Healthcare magic.Thank you for the query.You can have such fats,but try to have more frequent but smaller meals.Also,avoid alcohol and smoking completely. animal fats,especailly pork, will trigger gallbladder attack so you should avoid fried food,spicy food and food that cause bloating. And drink plenty of fluids with meal.Wish you good health. Regards </s>

<s>[INST] HI, im 17 years old and ive been sick for about 1.5 weeks now it started with runny nose and coughing and has now become a deep flemmy sound in my chest wen i breath heavily in and out and mi have a pain in the left side of my chest around my pec and wen i cough [/INST] Hello! you seem to have developed a respiratory tract infection. I would suggest you take a course of Tab. Amoxyclav for 10-14 days. Chest pain is quite common when we constantly cough. So once your Infection is controlled , your cough will reduce , so will your chest pain . Until then you can take simple analgesic like Tab. Paracetamol if you have too much pain.You can also get a Chest Xray done to ensure there s nothing else causing your chest pain . Hope my reply helps. Do drop in your valuable feedback. </s>

<s>[INST] I have a hard painless mass on my neck since april. Found it after a severe sinus infection in april. Had a ct scan 3 weeks ago and they said I have a sinus infection. No symptons of any thing except the mass on neck. I feel fine except for a few sweating episodes but they do not happen regularly. Took a zpak as prescribed but lump is still there. I am starting to get worried. [/INST] Hi, dear. I have gone through your question. I can understand your concern. You may have some cervical lymphnode enlargement due to reactive lymphoid hyperplasia. Or you may have tuberculosis or lymphoma. You should go for fine needle aspiration cytology to know the exact cause of that. Then you should 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] Hello doctor, Around a year ago, some red pimples started appearing around my mouth, chin, forehead, and my nose. These small red pimples create a red area when seen from far away because they are very small and inflamed. It never disappears. My skin always feels stuck and not flexible and with a mildly itchy or burning sensation. No matter how much moisturizer I apply, it does not help. I am using Eucerin atopic control moisturizer and a gel cleanser with Hyaluronan. I even tried using Metronidazole and tea oil, but again it did not help. I have also tried to stop using anything on my face for some days, but it stayed the same. I am 24 years old now, and I never had acne tendencies when I was a teenager, and my skin always looked very smooth. My birth control pill is still the same as it was when I first started taking it, which wad around ten years ago. I do not use steroid creams nor fluoride toothpaste. How can I get rid of this? It was not there before a year. I am attaching a picture of my face. Thanks. [/INST] Hi. I have seen the attached image (attachment removed to protect patient identity). Do not apply Metronidazole gel, as there is also erythema over your face. I suggest you try doing the following. Consult your specialist doctor, discuss with him or her and start using the medicines after their consent. For more information consult a dermatologist online --> </s>

<s>[INST] Hello doctor, My wife got scanned her thyroid by a novice user just for training purposes. She has been scanned in the hospital before, as part of an assessment of an autoinflammatory disease. At this time, they found a thyroid nodule (~12 mm) but no further investigation, as it seemed benign. Now, at the training scan, we observed the nodule had changed in shape, size, and it looks like there are some microcalcifications. But we are not the experts. We noticed it has changed. Could you give your second opinion on the attached images? [/INST] Hello. According to the american college of radiology thyroid imaging reporting and data systems (TIRADS), the nodule falls under category TR4, which defines it as moderately suspicious. However, as you mentioned, there is a change in morphology with the development of microcalcifications. Microcalcifications are the feature of papillary carcinoma of the thyroid, and therefore, it is essential to rule out that for which a fine needle aspiration cytology and biopsy (FNAC-FNAB) is recommended. Further, I would like to know if any necrotic neck nodes were detected. Let me know the results. I hope and pray that the nodule turns out to be benign and not malignant. FNAC-FNAB Ultrasound guided fine needle aspiration cytology and biopsy. Papillary carcinoma of thyroid and benign colloid nodule. </s>

<s>[INST] i really dont know if its a bipolar disorder or depression running with my brother. he gets really hyperenergitic during such span, lots of anger, no sleep, overeating, delusions. constant moss swings.this is third time he is being suuffering even though the medication is running. please help. he is unable to make a setteld career and life coz of this. [/INST] Hello He is having symptoms like hyperactivity, anger outbursts, decreased sleep (decreased need for sleep), constant mood fluctuations and hyperphagia. These symptoms are most likely due to manic excitement. In some cases of mania Delusions like Grandiosity, Paranoid delusions are also seen. Even on medicines he is showing such symptoms and is not getting relief. I would advise you to take him to his doctor for reevaluation. In acute excitement medicines like haloperidol, olanzapine etc can be used in injectable form. Once his condition gets stabilised then maintainence treatment in form of mood stabilisers can be given.Thanks, hope this helps you </s>

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

<s>[INST] Hi, I m sorry I started this before but closed out by accident. Is there any medical procedure available to create a sternum to attach the floating ribs. My son had his sternum removed and his ribs, collarbone feel like they are moving and clicking. His doctor told him it would be about 5 years before one of the ribs punctured his lung, heart or another organ and he would bleed to death. I can t believe with all of the medical break throughs discovered everyday that there isn t some kind of fake sternum developed. Please help or guide us where we should go? Thank you very much for your time. [/INST] Hi, Yes, you are right. Artificial sternum of metal is implanted to support the ribs and assist in respiration. You need to contact Cleveland Clinic in Ohio, USA. There is a separate Transplant Department which is doing all these transplants. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Kaushal Bhavsar, Pulmonologist </s>

<s>[INST] I am a 22 year old female who hasPectus Excavatum (I went to the doctor yesturday to see how bad it actually is) I have an S shaped spin and am scheduling other to tests to determine if there is anything wrong with my heart. The doctor says 1. the heart rotated, 2. the heart is misshaped or 3. there could a problem with one of my vavles (which he thinks is unlikely) but my heart doesn t sound normal so he scheduled a few tests in the upcoming weeks. Since my appointment yesterday, I have had this chest pain, sometimes pressure sometimes sharp but persistent throughout the day. Further, I have pain in my left shoulder, arm and neck and my fingers are tingling, also I am more tired then usual. Could this be from just them pushing on it yesterday? this makes me really anxious as to what could be going on with me. [/INST] It is imperative to perform a CT scan of the chest to calculate an index caller the Haller index to determine if you should be corrected surgically, there is an open procedure and a minimally invasive procedure called the Nuss procedure (treatment of choice in expert hands)The indications for surgery are: a haller index equal or above 2.5, significant changes in heart hemodynamics and/or aesthetic concern from the patient.Unfortunatelly you have passed the ideal age for surgical correction but it could still be performed. Greetings </s>

<s>[INST] Hello, I am having pain below my abdomen, (hip bone area) right side of my body. Pain has been on-going for about a week. Not sure if pain is due to my martial arts testing last Friday, or my working last Saturday. Hardest physical activity while at work was sweeping.I have applied a heat pad throughout, and rested as best I can. I have discomfort when I attempt to stand, or walking, which will spasm in the area.Thanks. [/INST] Hi,From history it seems that due to hard physical activity like sweeping might have produced heavy strain of back and hip area leading to spasm muscles.Take some analgesics with muscle relaxant medicine for 3 days.Ok and take care. </s>

<s>[INST] Hi, My niece who is 20 has an ESR of 140. The reason for her to go to doctor was a persistant allergic type of cough. Her chest x ray ia normal. Her TLC is also high abt 16000. Now they r going to do many further tests. My sister is very upset. Can it be due to the cough or some other serious illness? [/INST] Thanks for your question on Health Care Magic. I can understand your niece 's situation and problem. ESR (erythrocyte sedimentation rate) is marker of inflammation. So high ESR suggest presence of inflammation. TLC (total leukocyte count) is raised in infection, mostly bacterial infection. So possibility of bacterial infection is more in your niece 's case. She is having coughing with normal chest x ray. So possibility of Upper respiratory tract infection like tonsillitis or pharyngitis is more. So ask your sister not to panic much. Take her to the doctor and start antibiotics. She also needs antihistamines and anti inflammatory drugs. Ask her to drink plenty of fluids orally. Avoid oily and spicy food. Do warm water gargles 5-6 times a day. Don't worry, she will be alright. Hope I have solved your query. Wishing good health to your niece. Thanks. </s>

<s>[INST] For months (3-6) I have had a small round bump on the top of my hand. Not bruning, itching...nothing...just a small pimple like bump. Finally I started pick at it and it did get smaller...however now there is a tiny pin-prick of a hole in the center...but still a small red bump. tried to freeze it off but it did nothing. (thinking it was a wart) [/INST] Thanks for writing to HCM.As your symptoms suggest it is likely to be a ganglion. But it does need a physical examination for reaching an appropriate diagnosis and thence necessary treatment. So it is advisable that you visit a general surgeon. </s>

<s>[INST] hi i had endioM Cysts ans tumors removed the galbladder as well last year. a lower back pain started at first once a month and now more frequently daily... also have constant headaches and gained a lot of weight. my back was sore only when i lie down but now its constant on the right hand side, severe when i sleep.. very stiff and then the stabbing headache comes. ive been to dozens of doctors no-one knows whats going on. i also feel dizzy as well as nauseas. your professional advice will be appreciated. Tershia [/INST] just do back exercises,try to cut on weight with diet ,exercise.For headaches,get your Blood pressure, eye vision,and ears checked with specialists-your general physician may prescribe anti-migraine medicine if all other things turn out normal.Take it easy, you have had too many surgeries for good only and worrying shall make you feel more morbid. </s>

<s>[INST] Hi, within the last day or so I have discovered a lump about the size of a marble underneath my chin midway towards my neck. Around the same time I have been experiencing dizzy spells that r exacerbated by sudden head movements. The chin lump doesnt really hurt and it kinda feels like a swollen lymph node. Yet I have never noticed it there before. [/INST] Hi.Thanks for your query and an elucidate history.The lump under the chin is a lymph node unless otherwise proved . You may please take a course of an antibiotic and anti-inflammatory medicine under Doctor's prescription for 5 days. Consult an ENT surgeon - he will look after both the problems. The dizziness can be due to either a cervical spondilitis or problem due to internal ear. He will be in a position to decide the reason and ask you for investigations like X-ray or MRI of the cervical spine and mastoids. And start treatment for it. </s>

<s>[INST] Hello doctor, I have this mole on my back. I think it has been there for a while. My GP took one look at it and declared completely benign. I was wondering what sort of mole it is? Is it worrying? I used sunbeds frequently for about a year when I was younger. Never since. [/INST] Hi. Most likely it is a benign melanocytic nevus (attachment removed to protect patient identity). The worrying signs are a sudden change in colour, a sudden increase in size and shape. If you want to confirm whether it is benign or not, you can go for dermoscopy (noninvasive technique), skin biopsy. </s>

<s>[INST] should i be taking amlodipine, and lisinopril/hydrochlorithyozide ?I am a 55yr old woman apx 5ft10in. wt. is 240lbs. have had high blood pressure for apx. 10 yrs. high was apx. 162/105 before treatment. Also take synthroid because thyroids were removed in 1992. take chlorestorol med. pravastatin. level is apx. 184 was apx 220 before treatment. [/INST] Hello and welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice.You certainly need medicine and you are on fairly appropriate medicine. Continue with the same. However keep monitoring your blood pressure regularly. Also have low salt and sugar diet, and regular exercises. Avoid smoking if any. I guess sugars must have been tested.Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Sagar Makode </s>

<s>[INST] I have been having pain in my lower back, hips, and glutes (which is not unusual for me--I have been dealing with lower back pain for several years). For the past two weeks my pain level has been higher and I also have occasional stabbing pain in my left knee and ankle. Today I suddenly developed freckles on my legs for the first time ever. I had some sun exposure 2 days ago but did not get them on my chest or back, just my legs, where there was no significant reddening or sunburn. A month ago I traveled to Africa. Two weeks ago I pulled a tick off myself. Could this be more than just my typical back pain? [/INST] HiThank you for asking HCM.I have gone through your query. Your problem can be due to intervertebral disc herniation or osteochondrosis of lumbo sacral spine which gives such pain called sciatica due to nerve compression. It will radiate to knee and leg. You should get an examination with orthopedician which will give clue for that and a X ray followed by MRI of lumbo sacral spine might be needed to confirm that. For such condition i advice NSAIDs like aceclofenac muscle relaxants like cyclobenzaprine and neurotropic drugs. I also send them to physiotherapy along with this. Hope this may help you. Let me know if you have any further queries. </s>

<s>[INST] Sir, Thanks for the good info. I am 21 and was diagnosed with high blood pressure – 160/100. I got it measured for few days and reading were same almost. As the subject you dealt with, I am not taking any supplement. I don’t have any symptoms like headache, cramps etc. I don’t do work outs. I know that with such high blood pressure I can’t remain without the medicine. But I just want to know if there is an alternative of taking medicine life long. Please help me. I am pretty much worried. Thanks in anticipation [/INST] High blood pressure in ayurveda is termed as Urdhavag raktapitta. It happens when rakta is vitiated by Pitta. You might be having other symptoms like skin eruptions, Acne, excessive sweating, heat in hands & feet etc. The best treatment is going for Virechana karma & having rasayan after that. Panchakarma treatment can assure that you do not have to take BP medicine lifelong. </s>

<s>[INST] Hi, I met with an accident a week ago. my knee was injured as i fell on road. now what i see is below the knee my skin has become green in color and near the foot also I got little swelling with green color.Is is because I didn t got TT shot or if there is any-other reason what is that. Suggest me what should I do. [/INST] Hi, The greenish discoloration is clot of blood as a result of injury in the knee. The swelling below is part of same process. It has nothing to do with TT shot. Do not worry, both the problems will go away with time. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Gopal Goel, Orthopaedic Surgeon </s>

<s>[INST] I had my knee replaced 3 yrs ago, and in the first year a stitch did not close and I got strep and staph in the open wound...I went to wound therapy and the last culture was clear, but I still have ongoing pain in the knee since then, could that infection be deeper and not see in the wound culture. [/INST] Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. Any superficial infection which has not healed in quick time is t be treated as deep infection. I suggest you get an X-ray of the knee joint along with Complete blood count , ESR , ASO and CRP. Any infection in the joint would be evident in the X-rays now. Hope I have answered your query. Let me know if I can assist you further. </s>

<s>[INST] I have 3.9 wbc 55% lymphocytes and 55% histiosytes with no neutrophils present. I have an autoimmune illnesses already which we are aware this increases my risk of cancer and I have been referred to an oncologist as the csf results raise concern. is leukemia a strong concern here [/INST] Hi, dearI have gone through your question. I can understand your concern. Please send me reports of your complete blood count and peripheral smear examination. Your total count is not worrisome. Your have high lymphocytes percentage. It can leads to cancer. For definite diagnosis you should go for flow cytometry. It will give you exact diagnosis whether you have leukemia or not. Then you should 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] My Father Ultrasonography report shows left Kidney-1.7 x 9.6 cms size large well marginated heterogeneous mass lesion seen at the upper pole of left kidney with multiple retroperitoneal lymphadenopathy .Rest of the renal parenchyma appears normal with small cyst. Floating echoes seen in the left renal vein & IVC. [/INST] hi, welcome to hcm thanks for the query it appears to be renal cell carcinoma. you consult an Oncologist there is also need help for a nephrologist . its simultaneous coordinated action by the both take care </s>

<s>[INST] hi my pet poodle bit me or nipped me when i was giving him his medicine small bite but did break the skin (last nite)now it seems to be red and inflamed put alcohol on it and polysporin its so small feel silly going to er because its saturday and drs is closed [/INST] Hello,Welcome to HCM,Rabies is a disease which is transmitted by the dog, which is 100% fatal but it is 100% preventable by proper and adequate treatment. As you have been bit by your pet poodle. As there was a bleeding from the site of bite it is categorized into Cat III bite according to WHO categories and it is necessary to take both the active and passive immunization with Antirabies vaccine and Antirabies serum respectively. You have to take both antirabies vaccine and antirabies serum, You have to receive all the doses of antirabies vaccine on days 0, 3, 7, 14 and 28 (If your pet poodle is healthy after three dose of vaccine, you can discontinue the antirabies vaccine) and antirabies serum (Rabies immunoglobulin) on day 0 in and around the wound.In addition to this you should take Inj TT and antibiotic like tab Augmentin for 5 days. Thank you. </s>

<s>[INST] Hi I am a healthy 26 yr female. I had my daughter a year ago and only breast-fed for 6 weeks before she had to be put on special formula. Yet I am still lactating and its starting to get painful because I can feel the sensation like my milk is "dropping". Im worried something might be wrong with the milk ducts as to the fact when my daughter was 3 weks old I developed severe mastitus. please help. [/INST] Hi, I understood your query. -Dropping of the milk is a normal thing in lactating mothers. It happens when baby is not fed for a long time, it overflows. It's not a sign of milk duct problem. - Stagnation of milk in breast may cause little pain. - mastitis is a condition of swelling, hardness, painful/tender breast- which is many a times following some trauma / hard push to a lactating breast.Many times it is associated with fever. A healed mastitis is not known to cause defect in milk ducts unless it was treated by incision & drainage. * I don't know why your baby was put to formula- Enquire it to your doctor. - If there is possibility that baby will return to breast feeding- - You have to keep on emptying the breast, - Maintain breast health & wait for the breast feeding - But if doctor is advising to keep baby on formula milk ( ? lactose intollerance)-- you should ask medicines to stop the lactation, & get rid of the risk of developing an abscr=ess. Thanks.. </s>

<s>[INST] My 15 year old son has a skin rash that has developed across his upper back, up his neck, is now creeping around to his chest & upper arms. He says they are unremarkable. No itching or sensitivity. We gave him oral Benadryl which seemed to slow the spreading, but that s all. Any suggestions? [/INST] Its difficult to comment onthe type of rash without looking at it. It may be allergic, viral or fungal infection. You can apply Betnovate GM and look at the response, if its not going a dermatologist must have a look at the rash. </s>

<s>[INST] I'm 15 years old, and I was watching tv laying on my side. Then when I tried to move my chest hurt on the right upper side of my body. It got slightly better so that I could move, but I still can't move suddenly or sit up well and it hurts extremely badly when I inhale or exhale deeply. I don't smoke or do any drugs by the way. What is wrong with me? [/INST] Hi thanks for contacting HCM...According to your history it seems to be muscular strain pain....It will heal within few days....Rest done...If needed analgesic taken...Avoid strenous activity.Hot compress useful....Prevent movement causing pain....Take sleep in supine position.Avoid bad posture....If cough like symptom present then xray done to rule out bronchitis like condition...For that antibiotic given....If ribs tender to touch it could be costochondritis....If needed compression bandage might be prescribed....Take care.Dr.Parth </s>

<s>[INST] Hi Doc I am diagnosed with kidney stones a month back. This is because of a continuous pain at my left abdomen. But after a month the USG and CT scan report says that there are no stones left. During this period I drank a lot of water. Now, The pain has not yet gone it remains the same. I went of USG once again and told the problem, the radiologist doctor said it may be ameobic colitis. Please suggest what should the step I take to keep healthy [/INST] Hi welcome to Health care magic forum. Thanks for calling H.C.M.Forum. You are diagnosed with kidney stones one month back. after one months treatment U.S.G.and C.T.scan ,report says that there are no stones left, but pain is continuing in the left abdomen, another radiologist suggested it may be amoebic colitis. I advise you to consult a gastroenterologist for diagnosis and treatment. It may be amoebic colitis or simple urinary tract infection, if not found in urine examination culture and sensitivity of the urine may help to diagnise the infection. Wishing for a quick and complete recovery. Best regards. </s>

<s>[INST] Hello, I m a young boy with bad anxiety and I have a question. My girlfriend started taking the birth control pill Sprintec the Sunday her period started. She stopped taking it on the following Friday because of the side effect. It has been about 20-22 days since she has last taken it and about a week or two after getting off of the pill she started saying she feels nausea and gets bad cramping. We ve had protected sex and I always take caution and pull out before I finish. It is the 25th and she usually starts on the 1st. Could she be pregnant? Or are they side effect of getting off of the pill? And can the pill push her period back some? She did have spotting about 2-3 days after she stopped taking the pill. [/INST] Hello,Thanks for letting us know your health concern. I have gone through your query and would like to offer some information. Withdrawal effects of the oral contraceptive pill can cause the symptoms she is experiencing and also the spotting that she saw. If you are practicing only the withdrawal method, chances of failure are more. You need to use double protection for better result. She may also experience a delayed period in this cycle since she used the pill for sometime. Please get further help if she becomes overdue by ten days. Pregnancy chances are less in the current scenario. Hope this helps. </s>

<s>[INST] I had a hunting accident about 4 years ago . My right hand was amputated about midway between the hand and elbow. I developed neuromas shortly after the original amputation. I have constant pain since. Three different surgeons have operated on my arm with no success. What can I do to stop the pain and keep the. Neuromas from growing back? [/INST] Hello!Welcome on Healthcaremagic!Neuromas can not stop growing. They are just physiological after limb amputations. Surgical resection of neuromas by a neurosurgeon is a treatment option. Another treatment option for chronic pain are antidepressants like amytriptiline or anti-epilepsy drugs like pregabaline or gabapentine. You should discuss with your doctor on the above options. Hope you will find this answer helpful!Kind regards, Dr. Aida </s>

<s>[INST] What could be causing my husband to have BP drop? His is usually 12/80 but today it dropped to 55/40 when he walked in the house after going out to lunch and he felt extremely dizzy.Thirty minutes later I did the BP again and it is 75/58.What causes low blood pressure?Thanx Marilyn [/INST] HIWell come to HCMI really appreciate your concern hypotension may not be it self but there are certain condition which could cause this and that would be medical emergency that demand immediate medical attention, in my opinion better to get done the clinical examination there his blood pressure would be measured with authentic sphygmomanometer, hope this information helps, take care. </s>

<s>[INST] hi, Sir I am doing hand practice since last 10 years. Now my age is 24 . My question is that how can i get rid from this and what are the methods of this recovery? My penis have become lose and timing of hand practice is from 2 to 3 days. Kindly guide me to get rid from this habit. [/INST] HelloIt is good that you are aware and you are trying to get rid of the condition.Its obsession is bad.You should avoid provocative literature and videos.Try to concentrate in your job.Meditation etc are very helpful in this condition.Generally medicines are not helpful in this case.You may need psychological therapy if needed.Get well soon.Take CareDr.Indu Bhushan </s>

<s>[INST] i'hv got all the 4 ov my wisdom tooth pulled out 2 days ago...pain has lessened but my face has swelled up like a pumpkin and i do feel penetrating pain along the right side of my head moving upwards.and i am told not to eat hot and solid food.what should i do? [/INST] Thanks for using Health Care Magic.Read your query.The pain and the swelling will gradually subside .I would advice your to continue the medicine pain killers and antibiotic prescribed by the surgeon correctly.Do not apply hot bag externally , though you can apply cold compress intermittently.Do saline gargling ,but not vigourously .Keep good oral hygiene and stop smoking if you do by any chance.If the swelling increases or pain is out of control ,please report back to your dentist office so that he will have a look at it.Hope this was of help for you and wish you a speedy recovery.Thanks and regards. </s>

<s>[INST] Hi me and my girlfriend was messing about and i had a tiny bit of precum on end of my penis. I was trying to insert it into her vagina but it didnt go in. The tip of my penis was just rubbing her vagina so could she be pregnant? And i have Mercilon so could i use it for morning after pill to stop the baby? [/INST] dear Sir, there is a tiny possibility that she gets pregnant so it is bettet to use the morning after pill to eliminate any chance of getting pregnant </s>

<s>[INST] AOA, My father aged 63 weight 69 height 6feet now is suffering from hypertension since last 25+years and is also a heart patient since 1998. Since last one year he is suffering from renal problem. At this point in time his creatinen is 9.9 and urea 131. He tried many different medicines allopathic, homeopathic etc for a year but couldn’t find any improvement. He is on homo dialysis since the start of this month (June 2011) which happens twice a week and is now increased to thrice a week. He goes through the dialysis through the temporary Cathe while he went through a fistula surgery for the dialysis last Tuesday (21st June) which is now not working. I am worried about the infection in the temp cathe. . .Please Advise. These days the major issue he is facing is the shortness of breath I would like to mention here that his Hemoglobin is dangerously low. (5.9 According to the reports on 27th June, 2011), While it was 6.5 on the 1st of this month. The agony is that he had two RBC transfusions between the two tests still his hemoglobin is falling this way. Now after the last results i.e. 27th June he had another transfusion of whole blood on 28th and had an injection for Hemoglobin (Mircera 200mg) on the 29th now today on 30th he’ll have another RBC transfusion of RBC and then on the next dialysis which is scheduled on Saturday the third one. This way he’ll have 5 blood transfusions 4 RBC’s and 1 whole blood. Please guide regarding hemoglobin and the temp cathe, permanent cathe, fistula options. Currently he is under the temp cathe and had 1 failed fistula surgery too. Awaiting an earliest reply. Jazakallah khair. June 30, 2011 [/INST] walaikum wassalam. First of all it is important for you to know the condition of the patient and the diagnosis as patient has a complex of diseases. Patient has hypertension induced Renal failure and hypertension induced heart failure. The reports suggest that patient has advance renal failure and the residual function of kidney is less than 10 %. As you have mentioned that the main problem of the patient is shortness of breath. the causes of shortness of breath are as follow: A) As the patient has an HB of 5.5 which is of course dangerously low. This low haemoglobin is due to non functioning kidneys. Basically the chemical that causes blood formation in the bone marrown is derived from thekidneys. When kidneys lose its function the blood formation reduces significantly which cause Anemia(low Hb). This low HB results in shortness of breath because of the low oxygen carrying capacity of the blood to deliver oxygen to the body tissues. B) Heart failure is another cause of the shortness of breath. Heart functions as a pump that pushes the blood towards the tissue. Decline in heart function leads to Inadequate supply of blood to the tissue which cause shortness of breath and also the blood starts to pool in the peripheral tissues like lungs that also causes shortness of breath. C) Ureamia; patient has a significantly elevated urea and creatinine levels that shows that toxins have not properly eliminated from the body. These toxins in turn virtually disrupt function of every organ of the body. At this particular point of time the most suitable and life saving treatment is of course Haemodialysis. Three times a week is one of the best regimens along side the concomitant treatment for Hypertension and heart failure. Regarding low HB the most suitable treatment would be ESPOGEN( recombinant erythropoietin). This is the chemical that induces blood formation as mentioned earlier on. Patient is already taking it. If economically feasible it would be best if 2000 units be given twice a week subcutaneously. It will have significant impact on both low HB and Shortness of breath. Regarding the catheters it's necessary to know that long term dialysis needs fistula. The dual lumen catheters have a high chance of bacterial infection and are thus used as a temporary bridge to fistula. Formation of fistula to until it works takes up to 2 months. Central venous catheter( used as a bridge to fistula) have two varieties; 1) the first variety are temporary catheters that passed directly to central veins and are thus easy to use but have high rate of infection and less half life. 2) Permanent catheters that are passed into the central veins via a tunnel in the skin. The chances of infection are low and half life is more but these require high skill to pass and are costly. Thus if the patient has already one failed surgery procedure, it's better to use a permanent Catheter(the second variety) and then try for a second fistula surgery and if the surgery gets successful then remove catheter and proceed further with fistula. I hope you find this helpful. regards.Dr.Abdur Rehman Alozai. </s>

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

<s>[INST] Hi, I am a 24 yr old female from Bangalore. I have been facing hair loss and hair thinning issues. I was put on spironolactone and yasmin for a year since i was diagnosed with mild pcos although i did not have severe symptoms but had a few acne. During this time, my hair strands thinned out. I stopped taking these tablets in jan 2015. By april 2015, i had severe hair fall and it has not yet stopped. Soon after i stopped these tablets, i got my blood tests done for ferritin and vitamin d. My ferritin was 10 and vitamin d was 3. I took supplements orofer xt and drise and currently my ferritin is at 27 and vit d at 57. My hair is still falling out and I lose around 150-200 hair daily. What could be the reason for this? The hormone tablets already caused hair thinning and reduction in volume and now there is hair fall as well which makes my hair look much thinner. I have always had thick black hair and now my hair strands are thinner and brown in color. [/INST] Hello, You seem to have androgenetic alopecia characterized by thinning and hair loss from the top, mid and vertex part of the scalp. PCOS is very commonly associated with androgenetic alopecia in females. I suggest that you use Minoxidil 5% solution, 1ml, twice daily. In addition, I suggest you to also take an oral anti-androgen e.g. Finasteride tablet. Both of these are specific remedies for androgenetic alopecia. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Kakkar S., Dermatologist </s>

<s>[INST] Hi I was wondering if you might be able to provide a little insight as to why I would have random hiccups, daily, it's pretty frequent but usually are only like 2 at a time, every hour or so I find myself hiccuping again, I just want to see if this is any symptom to something that is possibly more serious. [/INST] Hi,Good Evening.Thanks for the query to HCM.I studied it in depth and I understood your health concerns.-Cause -for Random Hiccups-1-This indicates something irritating to the diaphragm from respiratory box or from abdominal box and is a grave sign if it occurs in terminally ill patients-indicating high urea.2-It may also be due to the Gastritis /Hepatitis/Pluritis ? or neural reasons.3-You should consult your physician ASAP , and fix any pathological-serious-reason for the random hiccups amongst the causes told above.4-Dont get scared and uneasy,but be cautious and act fast.Hope this would help you a lot to relieve you.Wish you fast recovery-and healthy life.Wellcome to HCM with more queries till you are satisfied.Have a Good Day...!!Dr.SAVASKAR M.N.M.S.GENL-CVTS,Super specialist and Senior Consultant-and Expert in Non-Curable-Disease therapy for Cancer,Asthma,etc,Rejuvenation therapy and Tissue failure -reversal therapies.a </s>

<s>[INST] Hi. I experience pain in both kidney s or the kidney area. If I don t drink enough water (I try for 64 ounces daily) it hurts to sleep on back or side. What could be causing the pain? I informed my Primary Care and we ruled our stones. This has been an issue for some to years. [/INST] HIThank for asking to HCMI appreciate your concern what the history given here this could be renal colic and the pain of this can be best managed with "Tab Dicyclomine with Acetaminophen three times in day, have nice day </s>

<s>[INST] Hello doctor, We had an unprotected sex on 13th day of her period. She took Ipill 19 to 20 hours after sex. Now on period due date she got light bleeding for two days. According to her, she always gets her bleeding only for two days. 28 days cycle. Before sex she got periods on 21st and after sex she got it on 19th of next month. Any chance of pregnancy? [/INST] Hi. Since you have taken emergency pill within 72 hours of intercourse, there is no chance of pregnancy. The bleeding could be because of hormonal changes due to the pill you have taken, it is withdrawal bleeding. So relax and do not worry. However, if you have a doubt then get back to me. Take care. </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 a recurring rash on the tops if my feet, my legs below the knee, my arms below the elbow and the top if my chest. it is small red bumps and extreemly itchy. I have not used any new medications, soaps or lotions. I have been experiencing seasonal allergy symptoms, and am using cetirizine. I have been using this for about 4 weeks. any suggestions? [/INST] Hi, It is very vital to get this examined as it could be any of these: tinea/eczema/allergic dermatitis/psoriasis. Cetrizine will only reduce the symptom of itching temporarily. I suggest you visit the dermatologist for a thorough examination and proper medications for the same. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Smruti Pevekar, Dermatologist </s>

<s>[INST] I have diabetic retinopathy and had a hemmorrage last thursday. Will the floaters in my eye cause me to see shadows that i might confuse with flashes? I did have a retinal tear in the other eye but it has been lasered and has been looked at by my specialist, but could the laser cause me to see lights as well? They are really flashing lights, just more flickers of lights [/INST] Hello, Thanks for the query.Following retinopathy (proliferative) if pre-retinal bleeding occurs, then the blood is not rapidly cleared from the posterior cavity of the eye. This can affect vision. After a certain period floater remain in the eye which can create some hindrance to the vision. Plus after the laser burns some flash lights are seen. These do not affect vision, but will remain. One need not worry about it. But it is essential to get a periodic retinal examination doen to see if there is any worsening of the existing condition. Plus strict blood glucose control is also a must. Thanks </s>

<s>[INST] Hi, I am going for my 3rd IVF attempt. I had positive results with 2nd IVF but in the 6-7th week I had early miscarriage . I had seen an ayurvedic dr at well and she had put me onto Phal Ghrutam and Garbhpal Ras which I stopped after miscarriage in Oct 2012. I have stage 4 endometriosis , mitral valve steniosis, chronic migraine and I suffer from on-going constipation as well which sometimes leads to fissure getting sour and bleeding. I am eating dals, veggies, fruits, nuts etc for good health. I want to get back to Phal Ghrutam and Garbhpal Ras as they also help prepare the body strong internally BUT my only worry is that are they both safe to take for a long time say 7-8 months and with cardiac conditions specially? Pls suggest if any side effects. [/INST] HelloThanks for your query.Do not take any medication without prescription.Specially when you are going in for IVF, you should not mix the two streams of drugs.YOu can have various side effects if you do so.The medications used in IVF itself are quite complex and too many.Please stick to prescription meds.ALl the best. </s>

<s>[INST] My 21 year old has numerous canker sores in his mouth that arose 5 days ago (he's never had them before). He now also has a pounding headache. Other than oral gel to ease the mouth pain, he has tried mouthwash and has swished with hydrogen peroxide (not at my advice) and the pain is tremendous.are the headache and mouth sores related? or should he just treat them individually? Advil is not relieving the headache at all (he is away at college and asking for advice.) [/INST] Hello and Welcome to ‘Ask A Doctor’ service.I have reviewed your query and here is my advice.Canker sores in the mouth can be due to a number of causes like nutritional deficiency, stress, eating more spicy and acidic foods or allergic reaction. In case if it is associated with other symptoms too then it can be due to viral infection causing cold sores. If the symptoms are too severe then better consult an oral physician and get evaluated. A clinical examination and if needed an oral swab culture test can help in diagnosis. For now to reduce pain he can continue applying numbing gels and also can gargle with a specialized mouthwash like magic mouthwash. Sucking ice or cool water rinses can help. Take Vitamin B complex daily. Take the soft diet and drink plenty of water. Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Honey Arora </s>

<s>[INST] hi sir am santosh.i have masturbated my pennis in my hands with 24 times wit semen coming outside.buuut yesterday ialso i did d same process but my pennis colour hav been changed to brown in the region of glan and i have pain now.please tell me the effects of this and also tell me if i had a sexual matter with my wife will leads to pregnancy with my masturbated pennis r not [/INST] Hello,Masturbation is usually safe and never unhealthy. The pain and discoloration you are experiencing could be due to the pressure you have applied during the masturbation process. Do not masturbate for a week. Masturbation will not hamper your sexual health. Therefore I suggest consulting a skin specialist for physical examination, diagnosis and treatment.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. K. V. Anand, Psychologist </s>

<s>[INST] I was on my feet for three days. And now I have lower back pain where I can't stand, sit, or lay down with out it hurting. I was laying down and turn wrong and I had a sharp pain up my whole back. I couldn't move for a little bit. Now I can't really do anything. What could have caused this, and how I can I fix this pain. [/INST] Could be some acute sprain or even a disc problem of spine. Get evaluation by orthopedic specialist who on physical tests can determine the origin of pain and whether radiological tests are required for diagnosis..In mean time take combination of methacarbamol 750 mg and ibuprofen 400 mg thrice a day after meals,, apply hot packs, take firm mattress to lie down and maintain the most pain free posture on lying down in any position. </s>

<s>[INST] My 6 3/4 year old son swallowed a piece of a ballon. He did not choke at all. Should I be concerned and what should I do? My son is about 48 lbs and 4 feet tall. He is behaving as he normally does. I am worried because I understand it is very dangerous to swallow broken ballons! Thank you so much! [/INST] Hello, Any foreign body consumption is injurious.Might get stuck at anatomical constrictions of Gastro intestinal tract.If stucked even it might causes perforation.Please carry out xrays- chest and erect abdomen to localize it.Diagnostic endoscopy might be of helpful.Please consult. </s>

<s>[INST] Hello my daughter had a fever a few days ago between 100.4 - 102 and then I noticed a sore on her lip like a cold sore and today I noticed her gums are a little swollen. I know she has 3 teeth coming in, could this be the reason for this? Also she has lost her appetite [/INST] HiWelcome to the HCMGum swelling can be due to the possibility of teeth eruption. So don't worry. In case she seems to be irritable and discomfortable, you can give her acetaminophen or ibuprofen syrup for pain relief.A slightly raised temperature (lower than 38 degrees C), but not a fever can be an associated symptom for which acetaminophen will be helpful.Your toddler may lose his appetite when he's teething. Chilled foods, such as a yoghurt or fruit purees, may soothe his gums and be more appealing. For further questions, do contact us. </s>

<s>[INST] My 14yr old daughter is Leidens Factor V mutation positive, opposing that, her blood that is not clotting has no granules surrounding the platelets. This in and of itself has been a balancing act, thankfully, I took her to a GYN whrn puberty wrecked havoc with her bleeding. He did a Mirena implant and all has seem well. 2 months ago she began having headaches, sever, and daily. Our family doctor did urine and blood tests, said he couldn't find anything gave her a migraine prescription, and we should just give it a few weeks. After a few weeks of no change I called her GYN and asked if this could be due to the Mirena. He had her come in, ran a CT scan, and then ordered an MRI when the scan came back showing "something," (the MRI tech said he believed the CT scan showed that the sack that contains the spinal fluid in the brain was enlarged and that was why the MRI was necessary.) The GYN called today with the results of the MRI and said my daughter is missing her septum pellucidum. My daughter has metabolic disorders, her body does not burn natural sugars, it stores them as fat. Are these types of problems connected to the missing septum pellucidum? She has no vision problem, is a 4.0 gpa student, and although she is somewhat clumsy and uncoordinated, she does not have any developmental problems. Is a missing septum pellucidum a serious issue? [/INST] Hi The absence of Septum pellucidum is genetic disorder having numbers of clinical manifestation, nothing much can be done, the only hope is newer genetic medicine. Take care of your baby, Have great day </s>

<s>[INST] had unprotected sex, he ejaculated on my chest and we both wiped everything off but didnt wash hands. After a few minutes I touched my vag accidently but my hands were dry. Once i realized i did that I quickly washed that area with warm water and soap but just the outside. Can you get pregnant from that? [/INST] Hello welcome to HCM.1. Almost negligible chance to getting pregnant for above reason. 2.Unprotected sex with out side ejaculation have more chances than you are feared off.3.Better you go for protection that worrying my suggestion.Any thing to ask?? Do not hesitate. </s>

<s>[INST] my daughter has mthfr. she has major fatigue, she is 14. i give her b12 and amino acids. she has low vit.. d she is taking 5000 grams a day now. she doesn t have epstein Barr. how dose folic acid help your body. what are your cells needing for proper absorption of nutrients [/INST] Like people need to eat food for nutrition ...folic acid is one part of nutrition of blood cells. If folic acid is low people get anemia.In thallasemia minor there are low levels of folic acid so patients are supplemented folic acid from outside... </s>

<s>[INST] I have epilepsy, I take Topamax twice a day, I also have diabetes. I get so tired during the day I fall asleep sitting up about 2-3pm. My diabetes is well under control. A1c's are 5-6. I have them tested about every 3 months. I do have seizures if I get upset or stressed or if I exercise. I have thyroid problems which makes my weight heavy. I do not eat much which is not good for my diabetes. Is there a better diet for me I should be eating? [/INST] Hi and thank you so much for this query.I am so sorry to hear about this diabetes and epilepsy. I have a strong feeling that your hypothyroidism is not well managed. This is because despite decreased food intake, you still complain of weight gain. Also, your fatigue is suggestive of symptoms of hypothyroidism. If your treatment has not been evaluated, I will suggest you get the TSH measured to see how well you are doing on treatment. At least, you know stress and getting upset would provoke seizure, try to stay clear of these provoking factors to spare yourself repeated seizure episodes. I understand it is not easy but then, it is worth it if you want a better quality of life.I hope this addresses your query fully. Thank you so much for patronizing our services and please do feel free to ask for follow up clarifications and information if need be. I wish you the best of health.Dr. Ditah, MD. </s>

<s>[INST] Had a vasectomy when I was 25, I am now 34. I find that I have mild to moderate pain in my testicles. I have also noticed that I sweat excessively, sometimes without even any physical involvement. When I sleep I wake up in puddles. Is this normal? [/INST] HelloI appreciate your concernLooking at your description this could be signs of epididymoorchitis or injury to testisI would like further information to help you better likeYour relevant medical history like diabetes or other metabolic diseaseSince how long you have this problem?I would advise you to consult your doctor for battery of investigations like urine microscopy as well as urine culture and sensitivity test and an doppler study of testisYou may require a course of antibiotics depending upon the reportsmeanwhile you can take ibuprofen for pain relief and wear scrotal supportHave plenty of fluids which will flush off the urogenital tractMaintain good hygieneThanks for your questionwish you a speedy recoveryBest wishes </s>

<s>[INST] My husband and I have decided to start trying for our first child together (we each have a child from a previous marriage). I was taking nuvaring and zoloft and he was taking prozac. I have not taken the zoloft since friday night and I took my nuvaring out saturday morning. Is there any concern with the zoloft? [/INST] Hi,     Thank you for choosing Healthcaremagic. You need to consult doctor to change to something which is less TERATOGENIC. Zoloft is an anti-depressent so you need to be careful.Please ask if you have more questions. If you are satisfied, please make sure that your ACCEPT my answer so that I receive credit. Good luck!! </s>

<s>[INST] i am 5 8 and weigh 180. I just had an endoscopy yesterday that revealed a lump in my stomach---the doctor said it could be from organs pushing into my stomach or a tumor....so they plan to do another endcosopy---ultrasound this time. what organs could be pushinginto my stomach and what causes this? [/INST] Hi, dearI have gone through your question. I can understand your concern. You may have enlarged spleen or some other mass lesion in stomach or peritoneum. You should go for ultrasound abdomen or ct scan abdomen. It will give you exact diagnosis. If needed go for guided biopsy of that mass. It will give you exact diagnosis. Then you should 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] I have had the mirena iud for 3 months with approx 6 days of no bleeding here and there. Mostly it's been a tolerable spotting, for the past week I have been on a heavy period which is becoming lighter. Although I've had clots throughout the periods today I have seen a somewhat large size the length of a small tampon. Should I be worried? I have also been becoming lightheaded when I get up from laying down or sitting down in my own mind I think this is maybe anaemia? [/INST] Hello,Welcome to Healthcaremagic.Yes you may have anemia.But this needs either iron tablets or injection depends on your hemoglobin level in blood.Regarding your spotting and heavier bleeding, It is very common with Mirena IUD for initial 3 to 6 months.Thus your body needs adjustment for the Mirena IUD.After these 3 to 6 months, your body may adjust and your periods may resume to normal.So you do not need to worry too much about this. If you are my patient, I will prescribe iron tablets for 2 months after checking the hemoglobin concentration in blood. I ask you wait for 3 more months and review.Hope this helps.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.Regards,Dr.Manjeth </s>

<s>[INST] I have a lump between my navel and penis area. When I do a hard cough the lump appears and it is soft to the touch, this is on the left side. The first time there was a ringing sound in my left ear for about a few days and the sound has gone. Now when I cough the lump has moved to the right side and there is a sound like bubbling. [/INST] Hi,It seems that you might be having inguinal hernia, direct or indirect inguinal hernia.Consult surgeon and get examined.Avoid constipation and cough reflex.Ok and take care. </s>

<s>[INST] Dear Sir, My father is aged 64, from past 1 month he come complaing of left hand pain. On 26th Dec 11 we took him to the Ayurvedic centre. They recommended for massage treatment for one week. First day after the massage the pain increased and it became very bad wherein he was not able to move his hand. So we took him to Ambedkar hospital in hebbal, Bangalore, got his x-ray done. Dr diagnoised that it was the muscle connecting to the spinal cord was hurting him. So he asked him to wear neck belt and gave him medicines and asked him to come for physiotherapy for a week. If the pain still continues then he has to be hospitalised and given treatment. Now one week is over he is finding difficult to sit, bend, move his hand and pain is very severe. Dr. has asked to go for MRI Scan and do the treatment. Pl. suggest if hosmat,bangalore is the best hospital for this treatment or what is the treatment [/INST] Hello,I would agree with his doctor on asking a cervical spine MRI, in order to exclude a possible spinal cord compression. In such case, surgery would be needed as soon as possible.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist </s>

<s>[INST] Hello doctor, I am 33 years old married woman with a kid, working. Recently, took a health check-up and found that my vitamin D levels are very low 5.24 ng/ml, vitamin B12 332 pg/ml. Every now and then I have stiffness in my neck and uneasiness in my knees. Can you please suggest me vitamin D supplements to overcome this deficiency, duration of intake and side effects, if any. I am a non-vegetarian and currently not taking any supplements and not under any medication. Should I be taking any other supplements apart from vitamin D considering my age is above 30. Apart from the vitamin D deficiency, I could see some abnormal values for lymphocyte percentage, lymphocytes absolute count, monocytes absolute count, total RBC, platelet distribution width (PDW) and platelet to large cell ratio (PLCR). Attaching my health report for your further reference. Please advise. [/INST] Hello. Your vitamin D and HDL are low, and iron levels are low normal. Rest all reports are fine (attachment removed to protect patient identity). So, for vitamin D, you should have tablet Uprise D3 (or Calcitriol sachets) 60,000 units with milk once a week for eight weeks and then once a month for the next six months. This will cure deficiency and also replenish your stores. May cause some gastritis, otherwise safe. For HDL, you do not need to have anything, but just have a healthy lifestyle like avoiding fatty oily food, regular exercises like brisk walking or running according to capacity. Also, for iron, have iron rich food like green leafy vegetables like spinach or jaggery, etc. </s>

<s>[INST] Hi, I am 43 years old, got married 10 months ago and don t conceive yet. In the starting after a month I did ultrasound and more tests and doctor said that I am pregnant, after few visit to her and FSH test she said it was just a chemical pregnancy which disappointed me a lot. Doctor insist me to go for IVF but I want to try to conceive without doing IVF. Later on doctor said I have some fibroids and one is inside my uterus which does not allow me to conceive that fibroid was removed in 16th of January 2014 and now I am taking Lezra tablets which I completed today. Need your help and suggestions please. I know that I am 42 now and it is not easy for me to conceive but still hoping for it. My FSH was also very high about 17.53 and I am on DHEA medication which brought it down to 6.84 now. [/INST] Hi I want to know regarding your AMH value and the follicles count on ultrasound. Actually your age is on a higher side.bangkok As your fibroid has been removed it will not be of much problem in conceiving but if your follicles count is low you might need IVF. as you have taken lezra tablets it is given to increase the size of follicles. So you can get repeated ultrasound done to find out if any follicle is forming or not. If follicle is forming then you can try naturally but if it is not growing you will have to opt for injections to make them grow. As the chance of pregnancy is only 7 to 10 percent with medicines and it is 40 to 50 percent with IVF, don't waste too many cycles in trying naturally. IVF is a better option for you. Hope I have answered your question. If you have any other query I will be happy to help. </s>

<s>[INST] HI i AM 26 YEAR OLD.I AM FACING PROBLEM OF SEVERE ACNE PROBLEM.ALSO TAKING HOMEOPATHIC MEDICINE BUT ITS NOT WORKING SO EFFECTIVELY....ALSO WHEN I FELL THEY ARE GETTING RECTIFIED ON THE SAME DAY SOME AGAIN POP UP.....AND ITS VERY PAINFULL.THEY ARE RED NOT WHITE AND ALSO LEAVING MARKS ON FACE,PLEASE SUGGEST ME SOME EXACT AND FAST WAY.......... [/INST] HI, THANKS FOR CHOOSING HCM, severe acne problem may be due to reasons like hormonal imbalances polycystic ovaries(though your periods are regular pcos may be present) exposure to dust and pollution infections so meet your doctor rule out the cause first some good tips: completely clear out your dandruff take less fatty foods, go for good diet and exercise keep your skin away from pollution(use a scarf etc) try to control cause of acne frequent facewash as well as hand wash stop fast foods seriously have fresh fruits,green leafyveggies ,fruit juices reduce spicy foods dont scrub the area inorder to get rid of pimples because it makes your pimples spread dont squeeze them ,it leaves pores and dark patches clear your pimples by following the above measures or meet a doctor... once your pimples get cleared completely then only treatment of pores and black patches can be cleared succesfully . this happens naturally after your pimples clear off or you may need medication also(ointments like melacare helps in clearing marks but this should be used after complete eradication of pimples) remember dont go for facials when you have pimples it worsens the condition natural remedies like neem leaf paste and tulsi paste application can help you with quick results but when you apply anything on face check that it suits you and only when you are sure it is working go ahead with it and also remember that when few creams are used initially acne gets worse but later it works very well so it is up to you to judge whether to continue or stop it hope i answered your query feel free to contact me for further queries thank you </s>

<s>[INST] Dear Doctor,i am in dharapuram in tirupur dist. In my problem my hair is reducing in day by day.i am using so many oil.but there is no improvement.my friend told v care oil to use.hence i don't no what?my mobile no :0000 if call to meRegards,m.premkumar [/INST] Hi, It may be androgenetic alopecia most probably. Consult the dermatologist for the perfect diagnosis and proper treatment. You may take tab finasteride with tab biotin. Apply minoxidil solution on the scalp. Keep the hairs trimmed. Do shampoo with ketoconazole shampoo daily. Do not oil the hairs. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilyas Patel, Dermatologist </s>

<s>[INST] 20 day before we come to know that my father is suffering from hepatitis B as well as 20% liver damage. he also had cirrhosis. After some of testing his medication has been started.from today noon he having sever pain in his abdomen and have loose motions. After consult to doctor we have given him econorm and plantocid.after 2 hours he having relief but now he is shivering like any thing and having fever 1.4 degree celcisus. please provide consultation regarding that. [/INST] Hello, For diarrhea, he has been given a probiotic tablet. The fever could be due to associated liver inflammation. I suggest you investigate him with sgpt, crp and cbc estimation for primary workup. Meanwhile, paracetamol sos can be prescribed. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Parth Goswami, General & Family Physician </s>

<s>[INST] i have not been to a dentist for three years after a bad treatment when he hit my nerve drilling and now i have a broken widsom tooth which is in half and a hole in another tooth,my teeth are yellow even tho i brush and my gums are sore and some times bleed and i suffer from tooth pain and i am scared of eating incase i get ooth pain please help me i want my teeth to look nice and pain free [/INST] hellooo...read thru ur query...first of all i must say that dont be tensed...nxt thing i can say is that dont be scared of dentist...bcoz of one bad experience...it might have happened by chance that resulted in pain for u.(which im also sad to hear)...that doesnt mean everytime he causes pain...(so cheerup)...regarding yellowing u dont have to be sad its natural that many people have yellow teeth (including mine).yellowing doesnt mean that u have bad oral hygiene or u dont brush..its due to excessive deposition of dentin beneath the enamel...and regarding hole in the tooth u have to go to a dentist get it filled(if deep rootcanal treatment mayne required which can be confirmed by xray)...and if u still want to whiten ur teeth there are procedures like bleaching or veneering which will be done by dentist...to prevent further caries to ur teeth brush twice daily use chlorhexidine mouthwash and do flossing...these all can reduce the bleeding from gums(gingivitis)..so be cool meet a dentist get it done...hope ur benefitted something from this reply..have a healthy day!!! </s>

<s>[INST] I have been diagnosed with IDC breast cancer. So far I have been told that the ER and PR receptors are weakly positive (2% ER and 20% PR) and the HER2 is negative. I have also had an MRI which shows one suspicious lymph node which I will have an ultrasound/biopsy on next week. The mass in my left breast has measured at 3.2 CM. I have been told that the treatment should be 5 months of Chemo (ACT) and then surgery. I am wondering if I should be seeking a second opinion or if this course of treatment sounds correct. From discovery of the lump to now, it has only been a month so everything has been moving quite quickly. [/INST] Upfront chemo followed by surgery is one of the suggested therapy for early breast cancer. On chemotherapy the lump may decrease in size and later the surgery could be a breast conservation on rather than a radical mastectomy.. Hormon receptor status is weak . So hormone therapy may not be very useful.. You are ilon the right course... Continue with the same.. Thank you </s>

<s>[INST] SIR, I DONT HAVE CHILDRENS .12 YEARS FINISHED.MY MAIN PROBLEM IS MY HUSBAND IS GOING UNDER DEPRESSION,INFERIORITY COMPLEX DUE TO HIS PROBLEM .WE TRIED ALL THE TREATMENT EVEN ICSI LAST YEAR THAT ALSO FAILED. NOW IAM THINKING ABOUT AT ANY COST AS EARLY AS POSSIBLE.CAN YOU ADVICE ME DOCTOR. SMITHA SUDHEER,KUWAIT [/INST] Hi Dear,Not having child and feeling depressed is a normal phenomena.nut you should come out of this with the help of psychiatrist.you and your husband is going through depression and both of you need consult psychiatrist.with the help of drugs and psychotherapy you feel well and think of other option of having child.You can contact infertility specialist for such complain.What are the reports of both of you suggest?what is the reason behind not having child?Thank you </s>

<s>[INST] There is a hard white ball on the edge of a fairly new scar on my forehead. Looks like a big whitehead but won t pop. No pain or itching comes from the spot. Just wondering if it is extra scar tissue or something else? Also, can it be removed or will it go away with time? [/INST] thanks for sharing your health concerns with us!you have to mention the size of the lumps; however, possibilities are: a sebaceous cyst or a keloid like thing! Not likely to go away with time please ask your surgeon!an FNAC TEST IS THE BEST WAY TO CONFIRM IT!all the best................... </s>

<s>[INST] hi i m 21 and this is the second time i had the implanon. Its been one month with it and im starting to feel numbness in my left arm. Also sometimes my arms starts shacking. I have also been getting symptoms like when i was pregnant. Should i be worry about this? [/INST] HIThank for asking to HCMI really appreciate your concern, what the history given here it said that you have device implanted and now you have numbness in your arm, and one more query is you had a somewhat same symptoms when you where pregnant in fact this is just your delusive state of mind otherwise this is nothing to take with your arm and the Implanon, no need to worry about it the numbness may due to some functional elements, hope this information helps you, have a nice day. </s>

<s>[INST] iam suresh my age 44. my son name sai charan.2 months back galbladder removed to himnow he suffering with pains. After MR scan Dr. told its a BONE TB. NOW TREATMENT GOING ON.BUT 2 DAYS ONWARDS HE FEELING HEAVY PAINS AT RIGHT LEG SIDE. HE NOT ABLE TO WALK / SITCAN I KNOW THE REASON OR ADVISE [/INST] Hi, I am Dr Gopal Goel Orthopedic Surgeon. In my opinion ,it could be Tuberculosis of the spine. Please get an X Ray of Spine and if possible MRI spine to see it tuberculosis has spread to bones . In this case The pressure of pus from TB can cause leg symptoms .The treatment would depend on the extent of disease. </s>

<s>[INST] Hi I am currently on my third cycle of clomid and my doctor has called me to say that my last day21 blood test showed my progesterone was 118.4nmols so he thinks I should be pregnant. Done a home test and it s negative though. Could I still be pregnant or is there another reason why my progesterone is so high? My previous day21 results were 58.7 Thanks Laura [/INST] Hello,welcome to Healthcare Magic.Urine pregnancy test kit may gives some time false negative results.Please do it with other brand kit and with first early morning urine sample.In first 3 months of pregnancy, progesterone level ranges between 15-90 ng/ml.It may be due to pregnancy but other factors are also there which change the level of hormone.Please consult your gynecologist for vaginal examination.Hope this will help you.Thanks for contacting.Have a healthy life ahead.Take care... </s>

<s>[INST] my 3 year old son has a constant bruise on the middle of the lower back. it is usually a yellowish color but today when i looked at it it has red spots. also when feeling it when he is standing up it feels like a bumb. but with him bending over its a semi large bulge [/INST] Hi, Skin conditions are best diagnosed only after seeing directly. I suggest you to upload photographs of the same on this website, so that I can guide you scientifically. Please revert back to me with images so that I can guide you better. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Sumanth Amperayani, Pediatrician, Pulmonology </s>

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

<s>[INST] Hello, I am 24 years old, I had been diagnosed with CIN 1 in june of 2012, after a normal pap in 2011. Then upon repeat test i had CIN 2 in aug of 2012. my doctor did a lazer ablation of my cervix in dec and my last 2 paps have been normal. but in july of 2013 my periods have been getting very irregular, heavy, and longer. I saw my OB and she prescribed birth control. A few weeks ago i had sever pain in my left pelvic area and went to the er. upon ultrasound they found a left "complicated hydropsalpix of 6.5cm with low level internal echoes and debris" rt ovary 4.1cm left 2cm. and possible endometriosis. The doctor in charge of my care has left the practice and My new OB that took my case does not seem to be concerned at all. Do i need a second opinion? I worry about cancer because my grandmother has had breast cancer twice, once at 35 and again at 64. 1 of her daughters (my aunt) has had ovarian cancer and another has had breast cancer. My father also has a sister with ovarian cancer. Given my family history, do i have a reason for concern? I am done having kids, i have 2, but when i asked my physician about the possiblily of a hysterectomy due to all the problems developing over the last year she said i was "too young to make that choice" Im just looking for another opinion. Thank you [/INST] Hi,Thanks for writing in.With history of CIN 1 and family history of cancers, your concern and worry are genuine. At the same time you have been successfully treated for CIN 1 . At 24 years age it is too early to get hysterectomy done when your CIN 1 has been treated. Ovaries are necessary for hormonal production in young women and should not be removed unless indicated.The complicated hydrosalpinx can be treated by colposcopy. You may take a second opinion on that concerning its management.Hope this helps </s>

<s>[INST] Hello, My friend is in a issue right now... She has a month old baby who has the sweats and has spots on his tongue. Her doctor told her to bring him right to the ER, and they probably will do a spinal tap. She really isnt sure what it is, can you help me? [/INST] hellothank you for trusting HCMdear any central nervous system infection we need to do spinal tap. for example meningitis (bacterial or viral), intracranial hemorrhage some times therapeutic use in raised intracranial tension. I think I answered to your question if you have more questions feel free to ask.take care </s>

<s>[INST] I am a heart patient undergone stent about 8 years back and very regularly visit narayana hrudalyala for periodic checkups. Now I have some dental problem and have gone to Narayana Hrudayala Dental centre at Rajajinagar. I need to undergo root canaling and Dr, Ramya who is attending me wants to have a clarification - as to if the local anesthisya that needs to be given i,e 2 ml solution NERVE BLOCK has to be given WITH OR WITHOUT ADRENALINE. Please clarify this. Thanks & Regards. S.Vasudevan - cell no. 0000 [/INST] Thanks for your query, I have gone through your query.The root canal treatment can be done under local anesthesia without adrenaline.The local anesthesia with adrenaline will result in vasoconstriction and increases the blood pressure so you can get it done under local anesthesia without adrenaline since you are a cardiac patient.Another possibility is you can also do RCT under local anesthesia with adrenaline if your blood pressure at the time of procedure should be within normal limits.To be on the safer side, get it done under local anesthesia without adrenaline.I hope my answer will help you, take care. </s>

<s>[INST] I have a stress test tomorrow at 8:00 a.m. and had coffee at 5:00 p.m. Should I reschedule my appt? The first procedure is CD/ED/794.31/LXA and the next procedure is ED/CD/794.31/LXA. I am 50 yrs old, 5 ft. tall, weigh 128 and have a family history of heart problems. [/INST] Thanks for your question on Healthcare Magic. I can understand your concern. No need to worry for coffee intake. You had taken it before 15 hours of test. So it will metabolize in the body and excreted into urine and stool. So it won't cause any effect of your stress test report. So don't post phone or reschedule your stress test date. Don't worry, you will be do great I'm stress test. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. </s>

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

<s>[INST] I have a period every 3 months and this is the first month i start to not have one. I have been reading a lot of things on the internet about pregnancy and signs. I have been having bad stomach pains, bad back pains, and now my legs are like cold skin deep and i took a test but it was negative. I still think i am because i still feel the same as i did before the test. Does this mean im pregnant? [/INST] HiI have gone through your complaints.sorry to say this that you may not be pregnant now with this history .you are saying you read ininternet.not having periods is not only symptom that wil tel pregnancy.in the presence of missed period ,breast tenderness ,nausea and vomiting if present go for urine/ blood pregnancy test or ultrasonogram.first one thing i want to tell you that evaluate for why you are getting once in 3 months.it requires complete work up and then its important to regulate your periods.if this is done defenitely the chance of conception increases.consult Dr for evaluation.Thank youRegardsVasundhara </s>

<s>[INST] when to sit down on toilet lid before getting into shower was naked slipped off and fell back into a porcelain or ceramic tile toile paper holder built into wal vary hard. the round point hit in my lower back toward area red and left bruise with in one hour i was running a fever and have been for two days. [/INST] Hello,Your symptoms could be related to a local infection or inflammation. I recommend going to the ER for a physical exam, a sacral X-ray study and some blood lab tests for inflammation (complete blood count, PCR, ESR).Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist </s>

<s>[INST] Hello doctor, I have a red color patch just below my neck. It just appeared a few weeks back. It comes and goes away. This time it looks a little prominent. It does not itch or bother me. I have attached photos for your reference. Gender: Female, age: 26, height: 160 cm, weight: 63 kg. [/INST] Hello. It is pityriasis versicolor (a type of fungal infection). Kindly follow the prescription. 1. Apply Clotrimazole lotion over the area BD for two weeks. 2. Maintain hygiene of the area. 3. Wash with mild soap and water. 4. Avoid Dettol and other irritants. You will get better. </s>

<s>[INST] hi, i am male 28yrs, i am suffering from like melasma and pigmentation (blackness like butterfly around side of nose ) doctor gave me melacare cream to apply, after a few days it was cured but the problem is when i stopped it comes again, so i was applying once in a 2 days from 5 years i want permanent cure for this what should i do...please help me [/INST] HI THANKS FOR CHOOSING HCM melacare cream contains hydroquinone,that help in improving the complexion,by peeling the outer layer of skin and bleaching exposing sensitive layer underneath it this cream may make your skin dry do use a moisturiser use a sunscreen lotion when you go into sun use this cream only at night not encouraged when you have pimples apply mild soap it is better to avoid such creams ,the benefits are temporary try to go for natural remedy like neem or tulsi paste try to rule out other reasons of melasma in men like hormone imbalances, family history application of mustard oil on face exposure to sun certain medications etc Do not use products such as soap, after shave or lotions that irritate your skin, because they may cause the melasma to worsen. After the melasma clears up, continue wearing sunscreen to help prevent it from reoccurring. HOPE I ANSWERED YOUR QUERY FEEL FREE TO CONTACT ME FOR FURTHER QUERIES THANK YOU </s>