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If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hi,I am a 61 yr old female. I am taking a multi-vitamin, 25mg hydrochlorathyazide, and .25 mg Alprazolam at bedtime. My mom passed away 5-30 of 2014. I understand that the holidays would be different this year for me, but I cant seem to get past the sadness. I cry easily. When invited to social things, I back out at the last minute and just cant be around big groups of people. This has gone on since before Thanksgiving. I have always felt myself to be more of an extrovert, but feel myself pulling away from people. I dont know if I should go on some medication to get me over this hump, or just tough it out. If I should, what would you recommend? Thank you for your time. ### output:	Hi, Well, grief after passing away of a family member is absolutely a normal phenomenon, rather a lack of which is considered not normal. The complaint that you have presented here is very much suggestive of a normal grief reaction. Scientific literature suggests, that a normal grief should last for up to 6-month period, its persistence beyond six months is considered morbid. However, the presentation and its duration may vary with cultural influences. Important here is to look for any associated symptoms of extreme low mood, suicidal ideation, etc., in case of which psychiatric assistance is required. I would suggest, that there is nothing major reason to be concerned at present, try to be with family friends and keep yourself busy in activities, be social, eat well and sleep well. However, if the symptoms still persist to bother, I would suggest you to see a local psychiatrist. Welcome for further suggestions. Chat Doctor.
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hello Sir, since last six months am sensing some symptoms like heavy sneeze when am exposed to mild dust,perfume odour, cold etc My mother is an asthematic patient since 25 years. am 32 years married and have 2 children.Just wondering if this may be a case of early asthma? If so, please suggest if I can be treated through homeopathy for better prevention. Thanking you..Mrs.Sashikala ### output:	Hello madam, Thank you for asking at Chat Doctor. I went through your history and would like to make following suggestions to you:1. If you have only sneezing and other nose symptoms but not symptoms like wheezing or breathing difficulty, I would suggest you not to worry about asthma. Sneezing and nose symptoms are due to allergic rhinitis only.2. For allergic rhinitis I would suggest you to take montelukast and levocetirizine for 1 month.3. I would suggest you allergy testing which will help you identify the substances you may be allergic to and also how to avoid them. Based on allergy testing, an Allergist-Immunologist may prescribe you allergen specific immunotherapy which gradually works on immune system to improve your allergy symptoms.4. In general, I would suggest you to avoid exposure to dusts, smokes and air pollution. 5. As you have asthma in family member, I would suggest you regular breathing exercises and Yoga & Panama to improve your immunity and lung capacity. Hope above suggestions will be helpful to you. Should you have any further query, please feel free to ask at Chat Doctor. Wish you the best of the health. Thank you & Regards.
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: MY BABY IS 5 MONTH OLD, SHE LOOK HEALTY, BUT THE LAST WEEK SHE DONT DRINK THE MILK LIKE THE WAY BEFORE, AND NOW SHE DRINK SOMETIME AND SOMETIME VOMIT, I TRY TO SEE IF IS HAVE UTI, BECAUSE COULD BE THAT THE ONLY SIMPTOM, BUT IS HARD FOR ME COLECT THE URINE SAMPLE, IM THE DOCTOR AND I THINK TO TRY ANY ANTIBIOTIC PROFILACTIC BUT I KNOW THAT IS NOT THE CORRECT, ALSO I KNOW CCOULD BE DIGESTIVE PROBLEMS, PLEASE TO ADVISE ME...THANK YOU DR PEDRO FROM GUYANA... ### output:	Hi, I am Chat Doctor. It may just simple viral or digestive problem. If otherwise baby is active, passing urine near normal as before, a slight less intake of milk may be due to viral or digestive, which will resolve in 3-5 days. A gross idea of urine infection can be made by examination of urine collected in an adhesive, sealed, sterile collection bag after disinfection of the skin of the genitals but can be useful only if the culture is negative or if a single pathogen is identified. Alternately one may go for suprapubic aspiration. At least microscopic examination can be done to get some idea of infection. Hope this answers your question. If you have additional questions or follow-up questions then please do not hesitate in writing to us. I will be happy to answer your questionsTake care.
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I am 56 years old male and working as an executive in a company and having physique of medium built. My fasting blood sugar level is 148 mg/dL and PPBS level is 207ml/dL. Cholesterol is 245mg/dL. The above lab result is based on the test carried out on 15.07.2012.Please advise the treatment required for the above ### output:	Hello! Thank you for asking on Chat Doctor! I read your question carefully and understand your concern. Your blood glucose test (post postprandial and fasting) indicate a low tolerance towards glucose and probable diabetes. I recommend consulting with the GP for a careful physical examination, a resting ECG and some lab tests : - HbA1c (which indicates the mean blood glucose values during the last 3 months)- kidney and liver function tests-thyroid hormone levels-blood electrolytes,- urinalysis, etc. An endocrinologist consult is needed to start the proper therapy, besides diet modifications (diabetic diet) and physical exercise (including loss of weight). Regarding your cholesterol levels, I would recommend performing also HDL, LDL and triglycerides levels. You should know that total cholesterol is not a pure indicator of cardio vascular risk. The most important indicator of cardio vascular risk would be Total cholesterol/ HDL ratio (and decide if you need any therapy). The increased cholesterol levels may be related also to the diabetes, but some lifestyle modifications (diet, physical activity and weight loss) are helpful, besides possible need of statins. Hope to have been helpful! Best wishes,
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hello. I started a few months ago with dry flaky skin on both sides of my cheeks. Then I noticed it eventually in my eyebrows. Since then it has gone into my hair line just above my forehead and it itches and burns. The sun seems to make it burn more. Lately, it is a constant burning and itchy feeling. I do notice on my scalp there are dry patches that itch. When I scratch them they seem to come off but eventually reappear. I noticed I now how dry patches if you will in my right ear as well. Im a very clean person, my skin is not oily, and that I know of its not in my family.I dont have insurance. Can you guide me in the right direction? ### output:	Hi, Welcome and thanks for posting your query to Chat Doctor. After reading your query the closest possibility of your problem appears to be "Seborrhea Dermatitis". This is a condition caused by multiple factors but in simple words you can understand it by fungal, genetic, environmental and other factors. It presents as scaly, flaky, itchy, and red skin over scalp, face and trunk region. Kindly follow the suggestions below:-Do shampoo of scalp every day.-Keep your scalp clean by combing every day three to four times.-You can do cold water compresses to reduce the intensity of itching.-Do not scratch or rub the skin as it can lead to further aggravation.-Avoid stress of any type.-You can take oral anti histamine like loratadine or levocetrizine under medial advise. As you have insurance, so I would recommend you to meet a dermatologist for best diagnosis and treatment. Hope these information will help." With good health wishes" Chat Doctor.
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: iam 52 years old ,85 kg weight 176cm height.i suffer cervical spondylosis in c5-c6.every day 1 have shortness in breathing and severe pain in left chest near the heart with pulseand burn in chest bones near the neck and stifness in shoulderssome doctors dignosed my case(angina pictoris)although i have no problems in heart and lungs.please help and advice. subhi siddiq-iraq ### output:	Hi Dear !! Thanks for your query to Chat Doctor. Read and Reviewed your query in context to your health issues. In the given scenario and history facts, You seem to suffer frogger induced Esophagitis-causing chest pain. This is so because lungs and heart are without any evidence on investigations. Chest bone near neck pains with burning. This is from the high acid contents from upper stomach regurgitating in to neck/ throat, causing chest burning with ? Angina like pains, in your case.Also, other causes of recurrent chest burning behind chest bone needs to be ruled by consults with ENT/ Physician/ Surgeon. Plan Suggested for your treatment-GERD causes need to be ruled out-with Consults from ENT Surgeon / Physician / Surgeon by appropriated tests with these doctors. EKG landholders nuclear stress testing would fix and rule out heart ailment involved in your chest pain. Anti-Acidity Chat Doctor. Lieu. Gaviscon-Alginic Acid-gel- 1 gm x 4 times a day x 2 weeks would control this chest pain-from esophagitis. So treating these causes is needed with proper
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I am aged 42, Male, Diabetic for the past 8 years (Gycomet GP1 tablets 1-0-1 half an hour before food ). When i checked my Hb1Ac last (end Feb13) it showed a reading of 7.3. My BMI is 20.5 Last month end i did a TMT test as part of my companys periodic health checkup and the result was Negative. The doctor said that i had done well! I worked out for more than 10.5 minutes and in the last stage of the TMT test my BP was 90/160. It is normal ? where during normal times my BP reading was 80/130. In the abdomen ultrasound it showed a subcortical cyst in the lower pole of the right kidney measuring 1.7cm x 1.8cm with a calcific speck seen on the wall of the cyst. Is this something to worry about? Do i need to consult anyone for this ? All my blood work result was normal. Also, all the other organs as per whole abdomen US scan was normal. P.S., Chennai, India ### output:	Hi friend, Welcome to Chat Doctor Heart rate and Blood pressure MUST rise during TMT - if not, it is heart disease! Your test is normal / you have reversed the values - it must be 130/80 - NOT 80/130 - the higher figure is systolic and comes first. The cyst is not big / on the cortex and calcified mean simple / nothing to do except repeat after one year...if symptomatic, see Urologist... Watch your lipids... Take tarnishing speedy recovery God bless Good luck
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: HI SIR , MY FATHER IS ON DIALYSIS IN 2 TIME IN WEEKLY... HE IS A DIABETIC PATIENT AGE IS 58 AND ACCORDING TO DR. HE HAS A KIDENY DISORDERS . CREATININE LEVEL AND UREA LEVEL IS HIGHFOLLOWING SYMPTOMS ARE SEEN :::1.BACKPAIN2. SWELLING BETWEEN BOTH LEGS3. HEADACHE. 4. WEAKNESS. ACCORDING TO DR. ONLY DIALYSIS IS OPTION ,, HERE MY QUESTION ANY OTHER SOLUTION ON THIS CONDITION ., ### output:	Hello. Welcome to Chat Doctor. I have read your question and understand your concerns. Once END STAGE KIDNEY DISEASE occurs there are only 2 options available to the patients.1. Regular maintenance dialysis for lifetime.2. Kidney transplantation. My advice to you is-1. If you can find a suitable donor for kidney transplantation then it will be the best treatment available.Meanwhile, maintain regular dialysis is essential for continuation of life. We can't stop dialysis of a failing kidney otherwise person cant survive more than few weeks.2. The symptoms you have mentioned are all due to kidney failure. Just ask your doc about in.erythropoietin to increase his HE levels. Avoid excessive salt and water use. Avoid any type of painkillers and excessive protein diet.3. Do his kidney profile every monthly and keep in regular followup of your nephrologist. Thank you.
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I had a root canal treatment (BMP) done a week back and had some pain in the following days along with swelling of the face (same side). I was told by the dentist (on phone, when i explained the problem) to have Clavam 625, twice daily for 5 days. The course got over yesterday but the swelling is not completely over. It is much better now (i would say 80-90% better), but some discomfort in the jaw joint while opening the mouth to full extent and I feel a funny taste and bad breath in the mouth too. I am due to meet the dentist again this week for crown cutting. Should I be worried about my present dentist or take a second opinion. Also, please note that my root canal was done on the upper tooth, right adjacent to another tooth where an earlier root canal had been performed, with post and crown around 5 years ago by a different dentist. thank you. ### output:	Hello and welcome. After going through the history posted here it appears that the infection has not recovered completely. Even after taking a course of antibiotic.Therefore, in my view please discuss with your present dentist regarding alternative antibiotic course like metronidazole and Cipro course too. Once the swelling comes down and when you start feeling better only then the next procedure can be started. There should be no hurry in this.Meanwhile, please do warm saline rinses too and do not be worried it would be fine. I would like to remind you that in case of diabetes and hypertension, any wound takes longer time to heal as you have not mentioned your medical history. Only when you are not convinced by your present dentist then please look for Endodontist in this regard. Thanks. Take care.
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hi so recently I was showering and when drying me self off I noticed a few pimple sized red spots behind my scrotum, for the most part they are not raised and do not hurt or itch, in fact if I had not physically seen them I would have never known about them. I work in a auto shop in very heavy pants so I have been getting normal sweat pimples occasionally but I feel the proximity and area of these are a little different. The last time I had sex was probably a month ago and it was fully protected with just a short bit of unprotected oral. And as of today i have been feeling a little bit clammy and off the weather but Intend to over myself so it could be that, along with recent lack of sleep the past few nights, but after drinking a bit of water felt a lot better. My question to you is how closely do any of these symptoms correspond to a std such as herpes. I know nothing is certain over the internet but a little peace of mind will make me feel better ### output:	Hi Heath symptoms that you have described is most likely to be a fungal infection which occurs after skin excoriation caused by sweat. Fungal infections can be treated relatively easily, but some modification in clothing will allow it to heal faster. Try wearing looser clothing or clothing that will not make you sweat as much. When sleeping, if possible, wear as little clothes that cover your pubic area as possible. Antifungal creams/ointments such as Ketone / Clotrimazole /Tamil etc. should be applied on the area. Remember, scratching will only allow the infection to spread faster and delay healing. A mild antihistamine will help if the itching is affecting your daily activities.
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I AM USING QUITE ALOT OF MEDICATION DUE TO SEVERE BACK INJURY. MY LEGS AND FEET STARTED SWELLING IN EXCESS, WITH RED LEGS, FEET TO KNEES. AFTER 2 WEEKS ON ANTIBIOTICS, SEVERE SWELLING STTLED. STILL SWOLEN FEET. DR. ADVISED ME TO STOP ATHROTEC. NEXT DAY ANKLES STARTED ITCHING, I EEL LIKE CRYING, CANT STAND THIS ANY LONGER, NOTHING HELPS !!!!! TODAY I STARTED WITH DIAREE.I ONLY HAVE 6" COLON, NO COLOSTOMY. LAST YEAR DIAGNOSED FOR NON ALCOHOLIC FATTY LIVER. PRESENT MEDICATION:LAURIKA 100MGATERAX FOR ITCHINGTECTACYMBALTA 60MGELTROXIN .05MGUROSEMIDE 40MGFENTYNEL 25MCG PATCH EVERY 3RD DAY ### output:	Hi, you are using many medicines due to severe back injury, feet swelling, itching, diarrhea. You are on medication for injury and painkillers usually cause swelling of foot, as there is itching as well it may be due to urticaria of foot also which also can cause swelling of foot. I prescribe to my patients with such symptoms levocitrizine, and diuretic along with your regular medicines. Thank you.
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I had a skin biopsy and it was demined that I have Vacuities. Although I ve only gotten the rash about 4 times I recently had 3 urine tests that are showing trace amounts of blood and protein in the past 2 months. I have now been referred to a nephrologist that I cant see for about 3-4 weeks and no one really seems too concerned except for me. I do have Celiacs as well and that caused a rash as well. Been gluten free since Oct 2013. I can see white floaties in my urine and try to drink plenty of water. Ive read that the kidneys can be involved so Im scared. They say I don t have to avoid anything (eating, drinking and so on) but again Im concerned. What will be the next logical step for my new doctor so I can be prepared? ### output:	Dear Patient, do you have more details on your skin biopsy? Was I T IGA positive? Your kidneys may be affected by Schooling Enoch purpura, ANNA vasculitis or a so-called monoclonal gammopathy of renal significance. Do a complete immunological test including C3, C4, ANA, EN ZA, Egg, IGA, IGM, Kappa and Lambda free light chains (serum) and total light chains in purines, STEP, PEP, total 24h proteinuria and luminaria, HBO, CV. This is a basic screening that gives us lots of information of what is going on. Then, if your renal function is good, and you have only mild urinary signs of activity, you can delay a renal biopsy, that otherwise is mandatory. Let me know,
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Good Morning Doctor, My father is heart patient. Last week check the angiogram Test. In the report 1. LMCA - Normal, 2.LAD- Mid Segment 90% long segment stenosis, Distal another tight lesion graftable.3.LCX- Proximal 70% stenosis, Mid Segment 70% stenosis after OM1. 4. RCA-Dominet, Osteal 90% stenosis, Mid Segment 100% occlusion, NO antegrade flow, good retrograde. This is the report, what is your suggesion sir, ### output:	Hello, Thanks for posting your query on Chat Doctor ...* Brief Answer:it seems that your father needs to do CABG(coronary artery bypass grafting).Explanation: My opinion is that multiple coronary vessel disease is an indication to do coronary bypass grafting, percutaneous coronary intervention in your father condition is debatable and may be non-beneficial to his condition, on the other hand, CABG would improve morbidity and mortality. I suggest my patients the following : consult a cardiothoracic surgeon about your fathers condition and adhere to antiischemic medications information provided by you is not sufficient to provide a good opinion. If someone comes to me with this condition I would ask them about other comorbidities and results of any other investigations you have done to your father.Conclusion: I suggest you consult a cardiothoracic surgeon and stick to your medications low salt in diet and If you have any further questions I will be happy to help, If not, you can close the discussion and rate the answer. Wish your father good health.
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I am a 32 year old female in relatively good shape and health. I have common allergies (mold, dust, ragweed, animal dander) that I receive shots for every week. I live in the southeastern United States where the pollen count is high right now. No health issues, including current illness or diseases. I quit smoking 3 months ago after smoking for 17 years. I have been a runner for the past 4 years, but now when I run I have a difficult time breathing. Even 24 hours after running, it is difficult to breathe. What is going on with my lungs? Why was it easier to breathe when I was a smoker? ### output:	Hello, Allergies are known to increase in intensity overtime if exposure to the allergen continues. Smoking is also an irritant and decreases the capacity of the lung over time. If you quit smoking, it is always helpful. It not only prevents further damage to your lungs and heart, but slowly they recover as well, but the absolute amount of recovery depends on the amount of initial damage. In your case, in my opinion, you shouldn't link your cessation of smoking with breathlessness; it's always the opposite. Focusing back on your allergy, If I was your physician, I would like to get you examine the status of your lungs as well as test your allergies to make sure you haven't developed a new one or that the other ones are in check. It would also be advisable to start an anti-allergic like Desloratidine 10 mg daily and Montelukast sodium 10 mg daily in this season, until pollen counts are below safe levels. I hope it's helpful. Thank you.
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I am 32 years mother of 3 children. I had normal deliveries for all my children, but the first one with 4 degree tear, the second one with Elective Episotomy and third one with 2 degree tear. I am having Umbilical Hernia soon after my third delivery which was on 8th march,2007, i don t feel any pain during my normal life. I have checked with a surgeon, he said that there is no need of correction as of now as it is small and advised for weight reduction as i am weighing around 85 kgs and my height is 151 cm. we are thinking to have 4th pregnancy after reducing some weight like 10 kgs, it may be after 10 more months. Will this hernia create complication to pregnancy and normal delivery. Should there be only c-section and hernia correction. please advise us. ### output:	No, an uncomplicated umbilical hernia should not necessarily create problems with your next pregnancy and delivery. Your history of 4th degree tear is much more concerning than the hernia, and you have already overcome that issue. If your umbilical hernia becomes more problematic (stuck out or painful), you could potentially require surgery. Hernia surgery in pregnancy is generally low risk and most patients tolerate it well. Overall, I wouldn't worry about your umbilical hernia until it becomes an issue. Many women have uncomplicated pregnancies and deliveries with these. The only time I would be potentially worried about your hernia is during pushing. The abdominal pressure could force intestines or other tissues out through the hernia, which would make your hernia more concerning. Good luck!
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hello Sir, I have 3-4 small & big lumps or muscles bolt in my stomach area, waist area, 1 on thigh & 1 on arm. When I am pressing them, its paining in that lump/ bolt only. I do not have any kind of other problems. I do not take any kind of tobaco items except rare beer montlhly may be once but not evrymonth , sometime. I am gym guy & do regular exercise. My height is 181cm & weight 78kgs & 32yrs old. I would greatly appreciate if you could suggest me what kinds of step i should take. Can I go for x-ray, what kind of xray.. Kindly suggest me on this.. Thank you!! Sincerely, Kailash ### output:	Hi Baileys. Thanks for your query. From the nice history you have provided of the multiple non-symptomatic lumps over abdomen and thigh, arm and waist, these look to be multiple Lipomas. Nice to know that you do not take tobacco and are a Gym guy. Kind of steps you should take ::-Consult a General Surgeon, get a clinical evaluation and physical examination to get a diagnosis.-Only FNAC is required.-The best way is to get all of them removed for 2 reasons 1. You get all the lumps out of the body before they get slowly enlarged.2. You get a certain diagnosis. Do not worry-the other ways is to get the following lumps out of the body:-Enlarging suddenly-Become painful-On joints-In muscles.Otherwise, get a confirmed diagnosis and relax. Remember there are no medicines for such a condition, hence do not try anything.
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I had been using candid b lotion about 2 weeks for my nail and and found my nail not improved but further to side of white from most of red part? It is a normal effect? What happen if normal nail used the candid b? If you have details of candid b lotion pls send me know too. Thank you ### output:	**1. You must be using the lotion for some fungal problem of the nail, or it could be due to anemia or vitamin deficiency, so it is better to consult dermatologist. 2. Candid B is a local skin application that contains Clotrimazole 1% [antifungal] and Beclomethasone propionate 0.025% [steroid.]PS. It is not effective in widespread fungal infections, for widespread fungal infections one need to take oral antifungal treatments. In addition, it is not very effective in fungal infection of the nails. [so could be the reason of no improvement even after 2 weeks]3. Some fungal infections can be complicated with secondary bacterial infections. Steroids in Candid B can complicate lesions caused by bacterial infection. Therefore, a doctor should examine the lesion before Candid B is prescribed4. Eat healthy diet rich in protein and calcium 5. Keep your nail clean and Chat Doctor. 6. Increase intake of biotin and use an application of moisturizer.PS. Biotin is helpful in making nails somewhat strong and thick: apart from biotin supplement you can also take natural source of biotin like: boiled eggs, cauliflower, avocado, whole grains.
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: My husband was transferred from the ICU rehap hosp to the main hosp ER for hypoxia, hypercarbia, hypertension, suspecting from sepsis and chest pain with very slightly elevation of troponin, most likely related to demand ischemia due to sepsis, needing to evaluate for acute coronary artery syndrome & shock. What is the meaning for hypertension sepsis, troponin, demand ischemia due to sepsis and then leading to acute coronary artery syndrome & shock? ### output:	Hello! Thank you for asking on Chat Doctor! Regarding your concern I would like to explain that sepsis is only one step to a broad spectrum of body distress; ranging from high-energy consuming demands to multi-organs dysfunction and failure, and to the final high-lethal state of septic shock. So at the beginning is present a hyperdynamic dynamic state; and possibly hypertension. After that, as micro-circulatory and cellular dysfunction follow (as the result of the microbiological and toxins effects), appears tissue ischemia throughout the body, comprising even myocardial ischemia (even in the presence of insignificant coronary lesions, or in their absence). This mechanism explains demand ischemia. Metabolism turns highly to an anaerobic one, and tissue injury markers appear in the blood (one of them is troponin, etc.). When this vicious cycle is not interrupted during early stage, this is a lethal disorder. Frequently it is found septic shock heart pattern (with diffuse and patchy lesions in the absence of distinct coronary lesions). Hope to have answered your question. I wish a fast recovery to your husband! Greetings!
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I have been having a heck of a time trying to sleep at night this past week or two. Both my ankles are sore and achy. What can I do to get some sleep, my ankles are not swollen but just very achy. I wear good shoes like Birkenstocks and they are fine throughout the day. ### output:	Here your sleeplessness problem could be because of pain in ankle and feet. And this pain you experience only in night after your entire day work. It means either you do lots of standing and walking work or your shoes are not comfortable for your feet, or you have weak bones with deficiency of vitamin D and calcium. Shoes you are using a good brand as per you, and you are comfortable, so it may not be an issue. Check your day activity if it involves too much of standing and walking work then I suggest taking break in between or take a break from job for few days. Next is you need to check with bone mineral density test to know your bone strength as well do blood report to know about calcium and vitamin D level. If its deficiency then take calcium and vitamin D natural supplement as per your doctor advice. I am sure one of this or in combination there will be a problem with you, and you need to do needful as per that. I also suggest to deep your leg in hot water daily before you go to sleep for 15-20 minutes and keep it floating in hot water, so water can touch your feet and ankle from all around. This will also help to give a pain relief and good sleep. Follow the suggestion, and I am sure it should help you. But if not then remember here I have given general guideline without any examination, so you should consult an orthopedic doctor for proper check up. Take care.
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I experienced some mild discomfort om my cheek last wednesday evening and woke up with an extremely swollen and painful cheek in the early hours of the morning so thinking it may be an abscess took 2 x 500mg amoxycillin and a panedine forte (500mf paracetamol. 30mg codiene).. Took a further 500mg amoxylcillin at 6 hourly intervals but when swelling increased went to ER and was given 2 lots of IV antibiotics plus prescriptions for metronidazole and amoxyicillin and had to report back the next day for follow-up.. all is fine swelling is slowly going down not too much pain now.. Had xray which showed no signs pf abscess or cysts or bone lesion or cavitys.. all was normal.. so wjere could the infectiom have come from,?? also my blood pressure is normally 130 over 85 and is usually good but I do take 5mg of civersyl (perindopril arginine) but since this cheek problem my blood pressure is 182 oner 90 pulse 80.. Is this high should I have more follow up??? ### output:	Hello, After going through your medical query I understand your concern and I would like to tell you that cheek swelling with high blood pressure indicates fluid overload in the body which requires proper evaluation and treatment. Kindly get a CBC, FT, Chest X-Ray, ECG and Echocardiography done and consult a physician with reports for proper management. Hope I have answered your query. Let me know if I can assist you further. Take care Chat Doctor.
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Sir I am 68 years old man . I have no diabetes or HTN or any cardiac dieases. I dont smoke or drink alcohol .I have bilateral peripheral neuritis in all four limbs detected by the nerve conduction studies since few years, probably seconday to the intake of Tarcolimus tabs ( as immunosuppressive for Liver transpalnt in 2000) .But I have only very slight sensory disturbacnes . Recently I have been having weakness of the dorsiflexion of my left foot since 4 months with partial foot drops and difficulty in walking. No root pain or any form of sciatica. The MRI showed disc bulging with encroachement fo the nerual recess of the L45 root. Will be benifited if I go in for lumbar discactamy though I have no root pain. Please advise me PMK Nambiar ### output:	Dear Mr. NambiarThe weakness in dorsiflexion and foot Chat Doctor. Your MRI has indicated of disc bulge and encroachment to neural recess of L4-5 So this can be taken as tentative cause. Well Mr. Namibia I believe I will not recommend surgery as the first option in such cases. In Ayurveda there is a procedure which is called Kate Vast in which medicated oil slightly heated is kept over affected area for about half an hour to 45 minutes. These oils contain analgesic, anti-inflammatory and muscle tonic herbs. I have seen excellent response in such cases. More so it is non-invasive technique. In case the cause is with muscles then fomentation with herbs and oil massage is beneficial. I wish and hope that this will cure you.
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: HELLO, my doctor just told me my ldl is over 200, he prescribed zocor. After reading up on statins I am very fearful, I have been doing natural things such as resversatrol,lecithin,milk thistle and garlic/nacin supplements for a few weeks, the test was done a week ago, but i was not taking the mention supplements regularly. I am now. I do feel when my chlorlestral goes up (funny symptoms) so I was not surprised that it was high, i didnt expect that high. Question; can I just continue the supplements or must I take the medicine he prescribed. I also had been eating pretty badly for a couple of months stressed/lonelines, but have done some diet changes and am excercising more. ### output:	Hi, Lipoprotein is a combination of proteins and lipids (fat). By this combination fat moves in the blood to reach the cell membrane to have its action. So Lipoprotein acts as a carrier of Fat and other enzymes also. There are different verities of Lipoproteins like LDL, HDL,VLDL and Triglycerides. Out which is High density Lipoprotein (HDL) is high in percentage it is good. If others are high it is not good. Color is a statin group of tab used to reduce the bad lipoproteins and enhances good lipoprotein. Supplementary therapy results not known, whereas Color is proved Chat Doctor. Better to continue color, associated with diet control and exercises. Zocor will not because for stress or ? Loss of appetite. Regarding loneliness - change of lifestyle will be helpful Best wishes
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hi I have been having lower back pain on my left side. Hard to get up and down and have to help my leg into the car. I have been using ice and heat and Advil. Doing some soft yoga stretches also. Been home resting it for 4 days. Not alot better. Is is a muscle pull or what? ### output:	Hi, I understand your concern regarding the pain. Since you have mentioned that you have low back pain we need to consider few things before coming to diagnosis and treatment. If you are a female:1) Make sure you have regular periods, no white discharges and any other women related problems.2) It could be a colic pain, kindly confirm if your pain is radiating towards your loin or else the pain could be due to our lifestyle habits like usage of computers, watching a lot of TV, bending while reading, heavy body weight sedentary lifestyle etc. Suggestions:1) Take an analgesic after prescription to just relieve from pain.2) Do not take analgesics excessively. They cause more trouble.3) You need to keep an erect straight posture of your back and neck.4) Do stretching exercises, when you wake up lie on your chest then using two hand lift yourself up, in an arc like position and then lie down slowly. Repeat his at least ten times daily. This will surely relieve back pain. You can watch online videos for such exercises.5) If your problem aggravates you need to get yourself physically examined and investigated through radiological methods like X-ray and MRI.6) An USG abdomen is also recommended in cases for a female, to rule out gynecological problems. Hope these suggestions help you. Contact for further follow up. With best regards,
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hi. I am a 34 year old female, I m 5 5 , 120 lbs., active (especially since I have a 3 year old-haha). I have been having pain intermittently since before I was pregnant with my son, on both sides of my stomach in the kidney area. It is a sharp pain that comes in waves, no blood in urine . I have had a history of UTIs, but haven t had one in maybe two years. I went to a general practice doctor last year about the pain, and she ordered an ultrasound of my right side (I am not sure why she didn t ultrasound both sides), and she said that I had kidney stones , but they were small and they should pass, she didn t request that I follow up with her. I have continued to have pain on both sides, though not as often. I have recently been experiencing a fluttering feeling on the left side of my back, almost like a muscle spasm , but I know it s not a muscle spasm. I am fairly certain it is my left kidney. Why is this happening? ### output:	Hi, Welcome to Chat Doctor, After going through your history it is possible you had small stones on right side, now you have some ureteric colic on left side as you suffered kidney stones, if you have tendency to have stone formation. Please check with Pro surgeon and get your Ultra sonography repeated to find if you have it sometimes it is possible clot is there or stricture is there. You should also check Uric acid and calcium level Urine R&M. Please take plenty of water and avoid dairy products for time being till you get result of investigations. Please do not worry if anything is there it can be treated easily. Take Care. Good Luck.
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I FORGOT TO MENTION IN MY YESTERDAYS QUERY THAT MY ECG AND PULSE COMES OUT NORMAL.I am a female of 48 years age . At times my hands start trembling and I get the feeling as if my heart is running very fast. This happens only for a few moments and I become alright in a couple of minutes. I have normal BP and Thyroid. However blood sugar fasting remains around 110 to 117 since last 10 years and PP sugar is always in normal range. My mind gets triggered to a depressive stage very fast to a level wher I try to commit suicide. Have tried atleast 20 times in the last 20 years but was counselled and saved by husband. My friends consider me very sweet and humble but I start getting extremely negative thoughts as soon as I hear someone even routinely commenting adverse remarks regarding me. These thoughts keep building up leading to a stage where I want to commit suicide. So I have 2 problems - 1. My hands tremble at times (2-3 times a year) with feeling of my heart running like a vehicle engine. 2. Getting emotional triggers leading to suicidal tendencies. - from India ### output:	Hello and welcome to Chat Doctor. Thanks for your query. I had answered your previous query. This additional information that your ECG is normal, confirms the fact that your problems are due to a psychological cause and not due to any medical disorder. Please visit a psychiatrist to have a detailed psychological assessment, so that further treatment and therapy can be planned. It is important that you realize that you need help and therefore take sincere and dedicated efforts to overcome your problems and improve yourself. Wish you all the best.
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hi doctor, My husband just recent done semen analysis which as show below : WHO Lab manual 4th Ed.2000 Volume : 2 ML Count : 109.00 10^6 /ML Motility : 30% Morphology : 8% Liquefaction : Abnormal Could you please tell me if it is alright with these semen result will do IVF , what is your advise if to use ICSI. Do you think the fertilization will success with these sperm quantity and quality?? What the reason for the semen liquefaction happened, By the way my husband did the test before this test 6 months ago and the result was different. Volume : 2ML Count : 81.00 10^6 Motility : 50% Morphology : 10% Liquefaction : Normal Could you please look through these tests and advise us what to do. By the way my husband take Menevit and fish oil and vitamin E . My email : YYYY@YYYY Thanks Fredon ### output:	Hi, Welcome to Chat Doctor, I am Chat Doctor According to the reports, motility of the sperm is lower than accepted value (>50% as per WHO1999) which was previously normal. And Morphology is also not within acceptable range. Liquefaction time is abnormal in recent test because of lower sperm motility. For IVF only few sperm with normal health and motility needed. That means good sperms are extracted from semen which are then utilized for IVF. So as there is some good sperm IVF can be tried. What about your husbands hormonal profile Like FSH and LH, prolactin? If you have not done yet go for it.
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I am from Kolkata(India), Now I am suffering from very much fear and anxity regarding rabies because once I had scratch by a dog aproxmatly 7-8 years back and was not vaccinated by myself. On that time I was not aware abaout that decease, but few days before I suddenly have noticed some article on internet that mentioned rabies can take effect by several years also. As soon as I notice this information from internet I started to feel very much fear and going to be crazy, some time I feel I would better to sucide before die with that pathetic decease.Please Please help me to get rid from that fear and kindly suggest would rabies realy take affect after 7 years if dog scratch. I am newly maried haiving younger brother, Mother and Father and I am the earning member of my family, Trust me Doctor I dont want to die now, I want to live with happy.Please advice what should I do. ### output:	Hi Biolab, Thank you for your query on Chat Doctor. Rabies will occur if that bitten dog infected with rabies virus at the time of bite. What about the dog? Is the dog is a pet or a street dog? If the dog is a pet animal and its health was normal even after 10 days of bite there are very fewer chances of transmitting rabies. Usually the incubation period for rabies is 20 to 180 days and most disease usually present within this duration. But longer incubation like 7 years is noted, but it is a rare phenomenon. Don't be panic and consult your Physician for your concern and get examined for your anxiety and apprehension. Hope I have answered your query, if you have any clarification please let me know. Regards.
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hi doctorAmjad: I am 42 years old male I am feeling episodes chest pain and right arm and leg three years ago ,before tow years I have suffered from episode a sound in my ears (not continuously ) .I have no history of any other medical problems except high blood pressure with average 130/90,average pulse 62 my family has no history of heart problems I have had ECG tests and an Echocardiogram more than one time and nothing has shown up except mild valve prolapsed and I have had MRI ,X-RAY,CT SCAN and all related blood tests were normal ,so doctor I some times feel a good health no pain and no sound in ears ,but some times I feel pain in shoulder down to the fingers and also same the leg with out chest pain ,and some times all simultaneously for along time (a week or 2 week or a month), I took one pill of gababntine 300mg for three months and now I have pills of aspirin 100mg and concur 5mg per a day. Are all I suffered from MVP? If I stay with these treatments is there any dangerous? Please help me. ### output:	Hello, Ahead. Thanks for your explanation. It will really give me an insight to your problem and ways in which I can help. I have reviewed your complaints and seen that you have a history of a mitral valve prolapse abut your blood pressure is not high. Its normal at 130/90 mmHg. Concur that has been prescribed will help with your chest pain as well as Aspirin, so no need for worries. If your chest pain continues, please see your attending physician for a review. Warm regards
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: HiMy 70 year old mother in law is on a ventilator and has pnuemonia. Her blood pressure is concerning the doctors as is very low. What is the likely hood of her surviving? She has fibrosis due to taking many tablets for many years. She was put on the ventilator 24 hours ago but she is still not responding to treatment ### output:	Hi Dear !! Thanks for your query to Chat Doctor. I understood your health concerns. My Impression-How Long Will She Services a very hypothetical and still philosophical question to be asked on this forum, as it has limitations of available information of the given patients. Still, Based on facts of your query, Your old Mother seems to suffer from- Recoverable OLD(Interstitial Lung Disease) with Non-Specific-Interstitial Pneumonia, which have better chance of recovery- as the Pneumonia itself indicates less of fibrosis, which is comparatively amenable to Ventilator Supports and are not prone to deteriorating lung respiration, as with IPF-Idiopathic Pulmonary Fibrosis, where the fibrotic part is more whereby, early VILA(Ventilator Induced Lung Injuries) lead to early deterioration from early percolation of the mechanical effects causing Ventilator lung injuries.AT the experts hands her chances to come are better in the situation submitted by your query. Hope this resolves all your queries to your satisfaction. Keep Me updated whenever needed, 24 x 7, to help you out by even, online tips for You, on weekly basis. Welcome for any further query in this regard. Good Day!! Chat Doctor. N. Senior Surgical Specialist. S. Genl-CVTS
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: i nedd a 4 tooth bridge. my Dentist said he did not want to do it because of antieslaw. I have another dentist that would like to try I have 2 united concordia dental programs that would cover %100 of procedure. What is your opion if my bridge does not meet the requirements of anties law? ### output:	Hello, Fixed bridges used to replace missing teeth need strong abutment teeth to support the empty span. How long is the empty span? The straighter these abutment teeth are, and good bone support are important factors. Your overall bite stability is a factor as well. Keep in mind that most insurance will have a period of time, often five years, that they will not pay for a replacement bridge again. This is a question to ask your treating dentist. I need more details, such as location, how many missing teeth, condition of remaining teeth, your gum and bone condition to give you a better opinion. Have you given consideration to implants? If you are not replacing a bridge or the teeth near the empty area do not require crowns by themselves, I would encourage you to discuss this option. You are wise to get multiple opinions. You may ask the dentist to show you models of your teeth and go over any concerns with bridge placement. This will help you visualize your bridge. I do think Antes Law is an important factor. This will generally determine how many abutment teeth are needed to be included in the bridge. Your bite and the stress on your bite all factor into how well the bridge will work for you. You should include an additional tooth now if there is doubt about how well the bridge will last. I would be glad to assist you with additional questions. I hope my opinion has been useful and assists you with your treatment decision.
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Is it possible for adderall to cause a false negative pregnancy test? I have numerous symptoms of pregnancy, though according to my calculations could only have conceived as early as the 6th of Feb. Starting this past Monday (the 14th) I became extremely fatigued, and since then became nauseous most of each day, dizzy, weak, headaches, food aversions and odd cravings, raised body temp (avg of 99.1 over the last few days), digestion problems, and am 2 days late for my period. I don t feel like I have a cold or flu, but just am miserable. Could I be pregnant or is there something else that might be going on? ### output:	Hello, and I hope I can help you today. Pregnancy symptoms widely vary between women, and nausea, bloating, headaches, weakness, and breast tenderness can all be caused by an irregular hormonal cycle as well as pregnancy. Furthermore, your basal body temperature goes up after ovulation, whether you get pregnant or not. The most common sign of pregnancy is a missed menstrual period. So in your case, the fact that you've had a negative pregnancy test is reassuring, however you really do need to wait until your period is due and if you are late, test at that time. If you perform the test at that time, it is greater than 99% accurate in diagnosing pregnancy. Adderall is a medication that is in a class of stimulants, which will not affect hormone levels, and it would not produce a false positive pregnancy test. I hope that I was able to adequately answer your question today, and that this information was reassuring. Best wishes,
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I am a female, 44 years old. For the past 5-6 days I have been having almost constant dull cramping in the lower abdomen area (no particular side) . I also occasionally have a throbbing sensation in the groin area. I have been to my ob-gyn and had a pelvic exam and had urine tested for infections. The doctor could not find anything wrong. He did not do an ultrasound or send me for further screening. My IUD Mirena is due to be removed (over 5 years) in the next couple of weeks and has been in since 2009 (over 5 years). Any ideas as to what this could be...I am concerned. My ob-gyn thinks I need to see a gastrointestinal doctor. Thanks. ### output:	Hi ! Good afternoon. I am Chat Doctor answering your query. From your history, it seems that the IUD IRENA is the culprit in your pain in lower abdomen. As you are already due to remove it soon, you might be relieved completely after its removal. If I were your treating doctor, I would have removed it along with a vaginal swab culture sensitivity test, and would prescribe a broad spectrum antibiotic covering both aerobic and anaerobic organisms. This would relieve your symptoms. As presently you do not have any gastrointestinal symptoms, I would defer referral to any gastroenterologist the time being. 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 Chat Doctor to clear doubts on your health problems. Wishing you an early recovery. Chat Doctor.
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: my son is 16 and was diagnosed by his pediatrician on Monday with enterovirus. a week ago he started with stomach discomfort. The fever started Sunday afternoon and spiked to 104 by nighttime. today is Wednesday and with Motrin and Tylenol the fever has only gone down to 100. He has muscle pains all over the body including his neck most recently. Today he has a slight cough and says its a little hard to breathe thru his mouth? I am a pharmacist and should know better not to read every detail on line, but when I read meningitis, encephalitis or pericarditis I am very concerned that maybe I should take him to the hospital? Is it normal for the high fever to last for so many days? Help :( concerned mom. THANK YOU ### output:	Hi, It seems from the history that your child has not gone through some important investigations E.g.. C.B.C, stool test to confirm it was retrovirus infection. As for now your child has got cough and difficulty in breathing with spike of fever. If I had wanted to evaluate the cause of these symptoms, I would suggest chest X-ray and sputum test first to rule out any bacterial or viral chest infection. As any infection can cause body ache, or muscle pain. Meningitis or encephalitis are inflammation in brain membranes and brain i self respectively, you should think about it when your child gets seizure, neck stiffness, confusion , paralysis or any other sign which is related to brain infection. So be relaxed, and you discuss further with your doctor after above-mentioned investigations. Chat Doctor.
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hi,I am JayaNaresh.My grand fa having nearly 70 yrs.He is suffering from fileria since 25 yrs.Frequently he is getting fever because of fileria.This problem is very civier since 5 yrs.Its releasing serum(like water and getting bad smell) from the effected area and its also swelling.The effected area is right leg below the knee.Please let me know the solution for this problem. ### output:	Hello Jay Naresh, I understand your grandfathers' problem. He has swelling of the legs from the blockage of his lymph vessels and this can lead to oozing of lymph if there is any scratch or abrasion. This problem is produced by the dead worms in his lymphatic system especially in the lymph nodes. His fever can be due to two reasons. If he has an infection of his leg or if he has microfibril in the blood. A night blood sample examined for micrfilaria may show it if it is present, and then it should be treated with the medicine Diethylcarbamazine (Betrayal). If there is infection of the leg abrasion or ulceration he would require local and systemic antibiotics. The important way to avoid infection is to keep the legs clean and take care that he walks around only with protective footwear and to wash the legs every day with water and mild disinfectant.Also, please check whether he suffers from diabetes which will increase his chance of infection. If he is in good health surgical removal of the swelling can also be considered, for which you can consult a surgeon. If you have further queries, I am ready to answer them. Best wishes,
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Our 5 year old son bumped his head on a metal bar above an 8 foot slide and lost his balance and fell off slide onto sand. He fell onto his side. He cried for 5-10 minutes. His eyes seem to be dilating fine. He is not in pain to the touch on his side or back. He was alert, able to see and speak clearly, After about an hour after the incident, He said he said he has a stomach ache, but went to bed easily as it was 2 hrs past bedtime. There are no bumps on his head. He is not complaining of other pain. We are out of town on vacation in a remote area. We plan to wake him once tonight to make certain that he is able to be woken fairly easily. Are there other symptoms we should keep an eye out for? Are there possible injuries we should look out for? We plan to call our pediatrician in the morning. ### output:	Hi! Good evening. I am Chat Doctor answering your query. What you are doing now is fine. You should be watchful of his level of consciousness from time to time and report immediately in case of any change other than a normal sleep. On his stomach ache, you have to see the pain does not increase in intensity, and he is comfortable eating and going to the washroom. In case of increase in the pain abdomen or tightness on palpation due to tenderness, you might have to report to the nearest ER. I hope this information would help you in discussing with your family physician/treating doctor in further management of your children problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing Chat Doctor to clear doubts on your health problems. I wish you an early recovery. Chat Doctor.
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: My husband s dog got infected with ear mites. was treated by 2 different veterinarians, was prescribed a cream to be applied in her ears and the fur around them, plus disinfectant soap to bathe her with. We are reasonably confident she is now free of the mites,but my husband is continuing with the treatment. The problem is that my husband is convinced he has them now on his body. He itches, specially at night. So he has been scrubbing his body with alcohol ( I do his back). I wonder if he really is infected with his dog s mites, or maybe is something else. His discomfort started soon after his dog was diagnosed. I do hope you will have some suggestion as to what to do or what kind of specialist he would need to consult. Thank you for whatever help you can give us. YYYY@YYYY ### output:	Hello, I understand your concern. I am Chat Doctor, infectious diseases specialist, answering your query. Yes, it can be possible to spread to Human. Some species of mites can spread to humans from dogs. So you must examine the area of itching very closely. If you find some burrow or mite attached to the skin, then your diagnosis can be confirmed. If the diagnosis is confirm you can use ivermectin tablet and gamma BHC solution under your doctors' guidance. Till that time you can use cetirizine for itching. You can also apply calamine lotion for maintaining moisture. Maintenance of hygiene plays very important role in clearing the infections. I will be happy to answer your further concern, you can ask me on bit.ly/ Chat Doctor. Thank you. ChatDoctorInfectious diseases specialist.
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hello, My name is Sean and I have been dealing with a brain injury since 1997 when I was in a car accident. since then I have traveled to Montreal for lots of testing and 2 surgeries on my right temporal lobe (resection). They were seeing activity on both the right and left temporal lobe. The simple partial seizures were so small that I was not seeing most of them myself. I am not having any trouble with the right side now. I am taking Vimpat 300mg and Keppra 2500mg to control the seizure activity but I am having some seizures still and all the pain after the seizures is on the left side. I am also having 6-10 left pains on the left everyday. The pains are very sharp. I am not seeing any seizure activity with the pain but these pains are the very same as the pains after a seizure. I am very active considering what I have to deal with. I have not worked or been able to drive in 5 years. My memory is bad and is getting worse. I love life so never have any negative thoughts. I like hearing any thoughts on my troubles. Thank You ### output:	Hi, Thank you for posting your query. I have noted your symptoms and appreciate your courage & positive thinking. You have done quite well considering the severe head injury about 17 years ago. Your symptoms suggest that you are still having minor sensory seizures. You would benefit from adjusting the dose of anti-epileptic medications. I would urge you to discuss these issues with your neurologist. I hope my answer helps. Please get back if you have any follow-up queries or if you require any additional information. Wishing you good health, Chat Doctor. Ly/
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I woke up with face and eyes swollen. i keep getting hives but this is not allergy related. they keep treating as such but in know it fluid retention. its either from heart or kidneys. my son is a kidney transplant and this was happening to him. my heart has enlarged 3 times its size in 3 weeks what do you think ### output:	Hi, Yes swollen face, puffiness of eyes with enlarged heart may be the signs of fluid retention. Fluid retention may be due to-1) Kidney problem2) Heart Problem (decreased heart pumping).3) Liver problem.4) Severe anemia (low hemoglobin). In case of allergic reaction swollen face and puffy eyes may be there but not the enlarged heart, though concomitant presence of heart problem with allergy may rare possibility. I want to know-1) Presence of heart problem, diabetes, high blood pressure, cholesterol problem.2) Any medicines are you on.3) Any symptoms of difficulty in breathing at rest or on walking, decreased urine output.4) Changes in sleep habit any breathing difficulty in lying down position.5) Cause of kidney failure in your son.6) Habits like smoking, alcohol. I would like to advise you to consult your doctor and get detailed clinical examination done. Following investigations help in establishing the cause of fluid retention1) Complete blood count.2) Kidney function test, liver function test.3) Urine examination including urine protein.4) Ultrasound for kidneys and liver.5) 2DEcho & EKG for heart. Depending upon clinical examination and test result further treatment can be planned.
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Dear Sir.. I have positive HCV C. First time it detect in 2008 when i got blood test . I take some medicines homeopathic. But my SGPT values not normal.. I stop treatment. But after 2 years one dr. suggest me for PCR Test. Its surprise me that my PCR is negative. My dr. said you are clear from Hep. C and no need any medicine.. But sir in 2012 i have opportunity to going abroad for job my friend who helping me for job.. So i do HCV Elisa .. When my report come it shows HCV Reactive 10.5 out of 1.00 cuttoff rate. So sir what i do to reduce or negative Elisa report... My pcr negative.. Suggest me any good homeopatChatDoctoredicine.. Thanks ### output:	Hi, Thanks for consulting Chat Doctor ! I am really sorry to inform you that it is not possible to turn HCV negative, once it is confirmed as positive. Please follow up with a Gastroenterologist undergoing liver enzyme tests to assess and treat liver abnormalities which are possible with HCV. I am not sure about homeopatChatDoctoredicine. Kindly reconfirm, whether the tests are clearly positive or not, as you are mentioning that it is positive once and negative some other time. These results depend on the antigens and antibodies they are detecting. I can comment more if I get to see the reports properly. Let me know if you have any clarifications, you can close the discussion and rate the answer. If you like my answers and wish me to answer in the future, bring it to my attention: Chat Doctor. URL link is as follows:http://doctor.ChatDoctor .com/doctors/
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I am a 45 year old healthy female. I was having lower back pain and weird throbbing pains in my abdominal area. also i have been having stomach issues. i went to doctor because I thought maybe kidney stone. she did a urine test and found small trace of blood in urine. She had me get an ultra sound of abdominal. During ultra sound tech said she saw a 3cm hemangionia on my liver. My doctor has ordered an MRI for next week. Can the small trace of blood in urine be due to the hemangionia on my liver and can the tech be correct about being able to tell that it is just a hemangionia. If it is a hemangionia could this be brought on my IVF. 7 years ago I did six rounds of IVF. i am a little worried because two years ago my dad who was very healthy did not drink or smoke had liver cancer. thanks for your help. ### output:	HelloYour ultrasound findings suggests a small hematoma in liver. It is not related to trace blood in urine. Trace amount of blood in urine may be due to UTI or other causes. Hepatic haemangioma is not a symptom of liver cancer. It is a benign tumor of the liver composed of hepatic endothelial cells. It is the most common liver tumor and mostly these are asymptomatic. It is of often diagnosed incidentally on radiological imaging. Haemangiomas are thought to be congenital in origin. Most hematomas disappear without treatment. It is also not related to IVF.MRI can be done for confirmation of haemangioma. Get well soon. Take care Chat Doctor.