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<s>[INST]Hi there, I have been having problems with my stomach for the past few weeks! I feel bloated and vomit after food but I dont throw anything up. I have also felt some lumps on my upper stomach right under my chest bones mainly my right side. The lumps are getting more and when I touch they hurt! Can you please give me some advice.[/INST]Hi and welcome to Chat Doctor. Bloating and vomiting are nonspecific symptoms, but these lumps you're feeling are definitely something that must be evaluated! You should do at least ultrasound to rule some serious diagnosis out. Usually such symptoms are caused by gastritis, gErd or hiatus hernia, so gastrostomy should be performed too. There is no specific cure. If you have only gastritis this is treated by changing dietary habits. You should avoid alcohol, coffee,smoking, fats and fast food, carbonated Chat Doctor. 1 hour after meal you should not sit or lay. Also lay with elevated upper body. If you are overweight you should do often exercise. But as I said, I really suggest to DI some imaging tests do investigate these lumps. Wish you good health.</s>

<s>[INST]I noticed bruising on both left and right legs after driving 12 hours straight (took four 1 hr breaks in between to get gas and food). Is this unexplained bruising related to sitting down too long in the car or it is something serious that I need to see my doctor.[/INST]Thanks for your question on Chat Doctor. I can understand your concern. In my opinion, you should consult your doctor and get done blood investigation to rule out any disease. Skin bruises on bilateral lower limb after prolonged Chat Doctor. So get done PT (prothrombin time), APT (activated prothrombin time) and bilateral lower limb venous Doppler. If all are normal then no need to worry. Hope I have solved your query. Wish you good health. Thanks.</s>

<s>[INST]My 2yr old grandaughter has always had trouble wth constipation and has been under her famly doctor, she has been taking medicine for quiet a while. My daughter in law is worried about her taking the medicine and asked for a Consultant to look at her. The first visit he said try a dairy free diet, this did not make any difference. Now she has a very swollen tummy and has lost weight. She has also been off her food the last couple of weeks eating very little. She has also cut another couple of teeth so we thought it might be that. The hospital have taken xray of her stomach, and she will be having some blood tests in the next couple of weeks. As you can imagine we are very worried, have you any idea what it may be?[/INST]Hi... Thank you for consulting in Chat Doctor. I think your kid is having habitual constipation. I have certain questions and suggestions for you. Questions:1. Did your kid pass motion or meconium on day one of life?2. Since how long is the kid constipated?3. Does the kid have any bleeding along with hard stools?4. How much milk does the kid consume per day?5. Does the kid eat fruits and vegetables (fiber diet) appropriately? You can get back with answers at the following link - www.ChatDoctor .com/doctors/ Chat Doctor. Natural methods are the best to relieve constipation.2. Constipation is a risk factor for UTI3. Maximum milk consumption per day should not exceed 300-400ml4. Minimum 3-4 cups of fruits and vegetables to be consumed per day5. Toilet training - that is - sitting in Indian type of lavatory daily at the same time will help a lot. Hope my answer was helpful for you. I am happy to help any time. Further clarifications and consultations on Chat Doctor are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.</s>

<s>[INST]Hi my name is sahira, 29 age, my husband is 31 yrs old. We are trying for a baby now I am taking Menogon 3 inj on alternate days and 1 pregnyl inj, how many chances of conceiving are with this inj? My hormones and my husband tests are clear. O have 2 fibroids in my uterus, does conceiving effect it?[/INST]Hi, Welcome to Chat Doctor forum. As you describe both of you are perfect in the tests of gynecologist, you need not have this treatment. But if 3 years passed after the marriage, most of the doctors use this treatment. Mention is a purified combination of follicle stimulating hormone and luteinizing hormone. To induce ovulation and enable pregnancy in women. In women, Chat Doctor is used together with other hormones called follicle stimulating hormone (FSH) and luteinizing hormone (LH) in the treatment of infertility. So there is every possibility of getting pregnant. It needs per vaginal ultrasound scanning at the time of expected ovulation, to see there is maturation of the follicles, and ovulation. If you don't get pregnant in the first time, you may become pregnant you will become pregnant in the second cycle. So never get confused, or get anxiety, as they may spoil the process. Wishing for a quick and complete recovery. Thank you.</s>

<s>[INST]My grandson has a bad case of acne and seen Christa Heard CRNP today. She recommended antibiotics and a cream to be applied morning and night, to make a long story short the medicine was 600. dollars and I am a single woman raising my grandchild needless to say he was very upset when we left the drugstore what or where do we go from here? Sandra[/INST]Hello and welcome to Chat Doctor. Thanks for your query. I understand that 600 dollars is a huge amount and it's even puzzling to me why a course of antibiotics and a cream would cost that much. I presume that you don't have insurance, so the only option would be to be prescribed more cost-effective medication. Furthermore, I would suggest that you can let the CRNP know that you cannot afford the medication and request her to prescribe something else more cost-effective and affordable. Since acne is not a serious condition, I don't think your grandson needs a very strong antibiotic or other expensive medication. Wish you all the best. </s>

<s>[INST]I am getting frustrated w/ my doctor. I have Hep C so he blames all problems on that. I have had a hysterectomy and now have terrible hot flashes but because I am a smoke he will not give me anything for that. I have a dozen nodules in/on my thyroid but my blood levels are in the high side of normal so I do not take a thyroid medicine. I have fybromalgia that I take gabapentin and tramadol for. For well over a year now I have been having these episodes where I become very hot, shaky, nauseous, and feel like I am going to pass out. They are getting worse. I am having severe headaches. They say I am not diabetic. Twice in the last 3 weeks it has felt like someone flipped me sideways and I have about fallen. It only happens for a few seconds. I am becoming very frightened by all of this. I have a doctor appt. tomorrow. But I don t know if he will listen to me[/INST]Thanks for your query at ChatDoctorAccording to your history you have undergone hysterectomy that could be a possible cause of your hot flushes, etc. You seem to be having some hormonal problem. You must visit a gynecologist and get investigated for hormonal tests. Furthermore, you might need hormone replacement therapy. I would like to add Chat Doctor. But you get you viral title done at 6 monthly basis and regular follow up. Can you guide me on your prior treatment? Take care!</s>

<s>[INST]Hi I have just been diagnosed with gallstones and awaiting an op. When I sneeze I get a very sharp stabbing pain in my lower Left hand side of the abdomen that travels 2 inches towards my belly button and then goes off . Is this likely to be part of my gallbladder problem or something else[/INST]Hi thanks for contacting Chat Doctor ... You have abdominal pain while sneezing ... Yes it could be by gall stone ... Here second possibility could be muscular strain also.... Avoid strenuous activity for it... Heavy weight lifting avoided. Take proper sleep posture while sleeping...If you need for pain simple analgesic can be taken... If your gall stone small and single then Adílio tablet that is made up of ursodeoxycholic acid can be taken that help in dissolving cholesterol in bile...Meanwhile, take low fat diet...fruits more... Take care... Chat Doctor. </s>

<s>[INST]hi i m 25 years old male and i m having problem with my hair as my hair suffer a substantial loss in the frontal and anterior over the last year when i consulted with a doctor she prescribe me with morr F solution and curlzvit tablet plz let me know the effectiveness of these medicine and their side effects. thanks[/INST]Hello, It may be used for hairless. It will work by increasing the blood supply to the scalp or affected area. Possible side effects are: 1. Dermatitis.2. Excessive hair growth on face.3. Headache.4. Itching. Culprit is a multivitamin tablet may be useful to avoid the hair fall. So I think I answered your questions still have queries please feel free to ask. Hope I have answered your query. Let me know if I can assist you further. Take care </s>

<s>[INST]My resting heart rate at the doctors office today was 132. I have narcolepsy and am on Adderall XR 30mg bid and Adderall IR 10mg tablets 2-4 times daily for afternoon sleepiness. My blood pressure was normal 120/77. Should I be concerned about my heart rate? The last time I was in the office it was 110 just sitting in his office.[/INST]Hello! Welcome on Chat Doctor! Regarding your concern, I would explain that your resting heart rate values are a little high, but they can be related to Adderall IR adverse effects (it is known to increase the heart rate by stimulating the sympathetic nervous system). As your blood pressure values are normal, the situation does not seem to be really concerning. But, I would recommend performing some other tests to be sure that everything is OK: - an ambulatory 24-48 hours ECG monitoring to examine your heart rate values for a prolonged time-complete blood count for anemia-thyroid hormone levels for thyroid dysfunction- blood electrolytes for electrolyte imbalance. If all these tests result normal, there is nothing to worry about. If your heart rate is persistently high, I would recommend discussing with your doctor on the possibility of reducing the dose of Adderall. Hope to have been helpful! Wishing good health, </s>

<s>[INST]My blood pressure has been low for the last month. 88/58. Now I just noticed 2 marble size lumps on the side of my neck. I had a fever earlier in the week and problems with allergies. Lost 55 pounds recently and lowered salt intake. Nor sure if all is related.[/INST]CLUMPS IN THE NECK CAN BE A INDICATOR OF INFECTION OR IT CAN BE ANYTHING SERIOUS LIKE CARCINOMA(cancer)sides of the neck has many nodes called as lymph node, its function is to trap any infectious agent in the body, swelling in lymph node indicates that there are infectious agents in body, as your lymph nodes are trapping those infectious agents, the size is increasing however in some case swollen nodes are an indicator of carcinoma its very possible that these enlarged nodes are pressing the vagus nerve which passes in the vicinity, vagus plays an imp role in maintaining blood pressure, increased pressure on vagus can lower the BP due to overstimulationbut a fever is indicative of ongoing infection would suggest you total leukocyte countdiffrential leukocyte count complete blood count test to rule out any ongoing infection if its normal then a Fine needle aspiration cytology of enlarged nodes should be done to rule out carcinoma</s>

<s>[INST]I m very terrified. I just noticed a very dark purple almost black lump in the back of my mouth about half an inch or so after my moler. Causes no pain unless messed with. WHAT IS IT?! Is it deadly?! Can I cure it at home?! Please say yes! WHY IS IT THERE PLEASE HELP!!![/INST]Hi. Welcome to Chat Doctor . I have gone through your query and can understand your concerns. As per your complaint a dark purple lump next to molar tooth can be due to a dilated vein also known as Varicose vein or a Varix. The lump might be due to formation of a small blood clot that got lodged in that area forming a Thrombus. It is not AA serious condition and will not cause any serious problem. It can gradually reduce in size on its own. If it is not ruled out as the cause other causes can be like mucous cyst or Muscle, Hematoma or a Hematoma. Confirmation can be done by getting a clinical evaluation done by an Oral Physician or an Oral Surgeon. Hope this information helps. Thanks and regards. Chat Doctor. </s>

<s>[INST]I have been experiencing hip pain/upper thigh pain that was intermittent and now is consistent. It is more of a burning type pain. The pain disrupts sleep and is painful while sitting still. I am a 53yr old female, 175lbs. Last year blood work shows my white blood cell count to be slightly elevated but I have seen a oncologist who didnt find anything. I also have been very tired and have been getting frequent headaches. I was recently diagnosed with a autoimmune disease Vitilago. I have seen a dermatalgist and endocrinologist. No one has any answer. Where do I go now?[/INST]Hi, thanks for writing to Chat Doctor. Hip and upper thigh pain which is of burning nature and is occurring more in sitting position especially in obese individuals (as in your case) is suggestive of NEURALGIA PARENTHETICAL. This condition results due to the compression of Lateral femoral cutaneous nerve (pinched nerve) at the level of groin fold. A few conservative measures which are effective in treating this condition includes - wearing loose clothing (avoiding tightness at the level of the waist and groin fold), Losing weight, taking OTC pain relievers such as acetaminophen (Tylenol) ibuprofen (Advil) or aspirin, Physical therapy to strengthen the muscles of the legs and buttocks etc. Other causes arising from the Hip joint are also to be excluded by having X-rays and MRI scans, which may also present with similar picture. So, I suggest you to consult an orthopedic surgeon for a detailed clinical examination and further management. Hope this information is helpful. Good day</s>

<s>[INST]Hi, my bf is experiencing syomach & adominal pains, lower back pains, pennis & balls hurt, anus hurts, trouble getting hard. He doesnt wanna move cause its that painful & this all occured after we had sex. What could be the cause & how can we make it stop for now until can see a doctor[/INST]Hello appreciate your concern for your boyfriend. Looking at your description this might be related to inflammation due to infection or injury during sexing my opinion you should ask him to have plenty of fluids with glucose water and fruits juices if he is not diabetic. You can also give him ibuprofen with pantoprazole for symptomatic reliefs him to take rest until he recovers fully Hope this answers your question please feel free to ask for further clarification I will.be happy to help you Best wishes</s>

<s>[INST]Hello im a 36 year old female and two months ago, ive been starting to have a lot of dizziness everyday and i feel tired all the time. even when im in bed, i feel nauseaus and dizzy. i m pretty sure im not pregnant, i excrsize regularly and i am eating right. what could be wrong?[/INST]Hi, First, you should measure your blood pressure and if it were high, you should receive a medical treatment, take Aspirin 160 mg, decrease fat and salt intake, do Lipid profile and do an ECG and an ECHO on your heart. Second, if you take oral contraceptive pills or a hormonal replacement therapy you should ask a gynecologist for help. Hope I have answered your query. Let me know if I can assist you further. </s>

<s>[INST]I had a skiing accident that caused a hematoma on about 50% of my hip a little over 10 years ago. My hip started to bother me when I laid on it about 6 months ago. Now the pain is to the point I cannot sit for more than 15 minutes with out my hip, knee, leg, and feet aching and sometimes get a warm sensation where the hematoma was. There is still a bump on my hip where the bruise was. I also never had any procedure for the hematoma. Should I see a doctor asap or am I ok waiting for my appointment with my general doctoc?[/INST]HelloWelcome to Chat Doctor, Due to blunt injury there can be hematoma collection. The bleeding that occurs result in hematoma collection. Over a period of time, as hematoma resolves it cause local skin symptoms around the hematoma. I would suggest you to apply ice and thrombhophobe ointment will help and take adequate rest. If required you may need to do blood investigation for prognosis and recovery. Take precaution to avoid infection around hematoma. If it continues to trouble I would suggest you to consult orthopaedician for further evaluation and treatment. Thank you.</s>

<s>[INST]i have chipping L5 L6 in my neck i was wondering if this could cause swelling around my neck even in the front. i am supposed to go for surgery but haven t heard from the surgeon yet. i am in a lot of pain in my arms and tingling down my arms to my finger tips.[/INST]Hithank-you for providing the brief history of you let me make a correction that C5-C6 comes in neck region and not L5-L6?.as you mentioned your history what I can understand is that you have pain & tingling in the arm up to the fingers.these symptoms arise due to Cervical spine disc pathology. For which I can recommend you to take physical therapy. This will help you reduce the pain and tingling sensation. Also on a later stages exercises will be introduced.in my clinical practice, I have seen many cases with similar issues and all response well to physical therapy.regards Jay In Chat Doctor. </s>

<s>[INST]My husband has a large, hard mass in the sternum. It has been there for about a year however in the past few months he has developed severe stomach pains, nausea immediately after eating and severe heart burn. His stomach constantly feels full and he spends a lot of time in the restroom. Is should also mention that about 8 years ago he was diagnosed with pre cancer of the stomach. This weekend the stomach pains were so severe that he could not get out of the bed. Could this be something serious? He is 44, 5 10 and weighs 210.[/INST]HI. This is definitely a serious matter as he was diagnosed to have a pre-cancerous lesion in the stomach. He needs upper GI Endoscopy. The mass on the sternum is not related. I would advise for this HERD like symptoms the following: Santa 12 hourly. Pepcid every 3 to 4 hours when on empty stomach. Add Risperidone or such motility regulators. Soft bland diet. No aerated colas / soda/ Chat Doctor. Early dinner. No late nights. Treatment for anxiety (as prescribed / needs a prescription by your Doctor)Lying in a reclining positional around after dinner. Think of the factors which increased the present problem, HERD, anxiety and try to avoid. If no relief, get Upper GI endoscopy done and get prescription for added Medicines. EKG for the heart n a safer side to rule out cardiac problems. This helps all my patients and should help you, hopefully.</s>

<s>[INST]I was just diagnosed with crohns desise a few months ago. Im also taking medicine for indigestion and heartburn. a few weeks ago I started this pain in my upper left abdomen, my gastro didnt seem concerned and my family doctor said it was a pulled muscle from coughing. pain has subsided for now. Last night I was woken up to severe stomach pain/ burning sensation in the middle of my stomach and severe nausea and started sweating. I could feel my heart racing. I did throw up a little and it calmed down a little bit but am still nauseated this morning.[/INST]Hi. Thanks for your query. You are suffering from Crowns, this is a recurrent problem and most probable be the reason or the pain in abdomen you have. It is better to get re-investigated for the fresh attack of pain, nausea, vomiting, sweating you had as there may be another problem associated. I would advise you the following:Get the blood, urine and stool test done. Standing X-ray of the abdomen and Ultrasonography. Get a course of additional medicines if advised so. Get PPI, Domperoidone, antacid. Alter the diet to suit the intestines. If required you can always take a second opinion of another Doctor or Gastroenterologist.</s>

<s>[INST]I have suffered from what seemed to be RA for five years now. I was treated with methotrexate yet continued to suffer joint pain at times when having allergic reactions. I was tested by an allergy doctor and told I did not test positive to any known allergens on tests. Yet continue to have knee joint pain and itchy tattoos that turn bumpy throughout the year. On and off. I discontinued Methotrexate treatment and I went on a hunch and was treated for Lyme disease. I am around rescue dogs as a hobby not all the time. I got better and was able to walk again. However now I find whenever I have allergic reactions itchy tattoos sinus issues my knees become painful again. Any ideas? Tatto related?[/INST]Hello, I can understand your concern for side effects of tattoos. After analyzing your query it appears that you are quite stressed regarding the tattoos and its side effects. Though in general if the tattoos are made in sterile procedure then there is no any harm of the same but in case if the tattoos are carved by unsterile needle or is made with infected needle then can transmit multiple infections. Temporarily it can cause secondary infection and later on the tattoos can cause permanent darkening of the skin which is actually difficult to be managed. You can take further guidance from a family physician. Take care.</s>

<s>[INST]Hi, my 79yo mother noticed a lump in her neck on the left side, mid jaw line, extending from just below the jaw to the middle of her neck. It is soft, no pain. She has been running a low grade fever and has been very tired. The doctor ordered a ultrasound which was inconclusive and sent her to a surgeon. She is getting a CT tomorrow as the ultrasound showed a nodule on the right and a mass on the left. The surgeon said whatever it is it needs to come out. What are they suspecting?She does not smoke or drink, has a history of atrial fib and was on amiodarone until her doctor discontinued it 2 months ago due to high liver studies. she is now on only beta blockers. Her thyroid studies at her last physical 6 months ago were normal.[/INST]Thanks for your question on Chat Doctor. I can understand your concern. By your history and description, your mother is mostly suffering from thyroid cancer. Her CT report clearly mentioned left sided mass and right sided nodule. So possibility of papillary thyroid cancer is more. Old age is an independent risk factor. It is usually painless and present only as enlarged mass in the neck. So better to get done fine needle aspiration cytology (FNAC) for the confirmation of papillary thyroid cancer. Consult oncologist and plan future treatment. Hope I have solved your query. I will be happy to help you further. Wishing good health to your mother. Thanks.</s>

<s>[INST]since i made a fall last year i hVE RECOVERED HOWEVER/ FOR THEPAST MONTH IT STARTED WITH MY TOES GOING NUMB and now it feels like IT IS TRAVELING UP TO MY ANKLES. AM ON VARIOUS MEDS MEDS FROM MY G P BUT THIS NEW ONE IS DRIVING ME CRAZy i can NO LONGER WALK WO A WALKER nEED HELP IN ORDER TO WASH AND DRESS LET ALONE KEEPING HOUSE AND DRIVING MY CAR ID THEREANYTHING I CAN DI TOI HELP ME OR WILL THIS GET WORSE UNTIL IT KILLS ME THANKS. AUDREY[/INST]Hi, Thanks for your query. Numbness in the toes indicate that there is some sort of neurological disturbance (impaired conduction of nerve impulse) in the involved nerves. This may result due to compression of the nerve at some level during its course or may also result due to some systemic diseases. A detailed clinical examination and few investigations like EMG & Nerve conduction studies are needed to establish a correct diagnosis of your problem. I suggest you to consult a Neurophysician and follow the advice. I do hope that you have found something helpful, and I will be glad to answer any further query. Take care</s>

<s>[INST]Hi sir!I am sekhar and 33 years of age.I have a pimple in my head of penis and a hard lump in my groin area since last 10 months.Recently i have examined those by 2 doctors(surgeon) and they told me that the lump is a cyst and it is now too tiny to remove.Sometimes i feel slite pain(rather irritation) from the lump but the pimple is painless.what should i do?[/INST]Hello, It would be of great help if you could share the picture of your cyst so that I can comment over its treatment. Cysts are usually fat deposits below the skin or a clogged hair follicle. If its causing pain go and see your doctor again to see if It's infected or not and get your treatment accordingly. Hope I have answered your query. Let me know if I can assist you further. Take care Chat Doctor. </s>

<s>[INST]I had a complete hysterectomy 8 yrs ago. I WAS PUT ON A NUMBER of ssrs and finally found Prozac to work. I was put on Xanax for anziety. having more issues with panick attacks due to high stress last year. dr is talking mood stabilizer oxcarbazepine. will that help[/INST]! If your diagnosis is just anxiety disorder and not bipolar disorder, then oxecarbazepien will be best avoided. There is many milder and better molecules which can help you and will not require many dosage level monitoring (like oxecarbazepien). You may go for venlafaxine or paroxetine, or combination with Aquitaine. These all are good at handling anxiety and panic attacks. Your doctor will know about them. Hope this helps you please feel free to ask more questions for clarification</s>

<s>[INST]I am experiencing server pain from my crotch to my feet. I ve had a triple by pass in the past. In the last 6months I ve had swelling and extreme pain throughout both legs. The pain often brings me to tears. What caI do to comfort my legs until I see the doctor on Monday. I need relief.[/INST]Hi, It's likely a sciatica. You're It D level, x lumbar spine AP/ Lat view and further may need MRI if x-rays are not informative. The treatment for this is physiotherapy to release the nerve compression so may visit the nearby physiotherapist. Till the time you can have tabbed Neuronion forte once a day which is a nerve vitamin and Diclofenac/Ibuprofen. Also, you should get nerve stabilizer prescribed like Tab Pregabalin will stabilize the nerve and reduce pain. Etc. You need to visit orthopedic for all these investigations. Hope I have answered your query. Let me know if I can assist you further.</s>

<s>[INST]Hi, I got a flu shot a couple days ago. For a few days my arm was very sore (that s usual, I know) but then three days ago I realized my pain moved up to the base of my neck where I know feel a lump under my skin. Is that normal or should I seek Medical Attention for it? If it is normal, how many days do you usually keep it?[/INST]Hello, I read carefully your query and understand your concern. Your symptoms seem to be related to a side effect of the shot. I suggest using anti-inflammatory medications such as Acetaminophen to relieve the pain. I also suggest using cold compresses for local application. The symptoms may last for a few days. Hope my answer was helpful. If you have further queries feel free to contact me again. Kind regards! Chat Doctor. </s>

<s>[INST]my baby is 6 months and has a red rash behind his ears and redish eyelids, he is more tired than usual. Noticed the rash 24hrs ago and now it has spread over his back of his head and little on his cheeks and under his chin. It is red slightly raised, does go when you add pressure thrrough the glass test - He is very alert and responsive and no change in himself, Nappies are normal and no vomitting. temp 36.4. Any ideas or help you can give Dr is helpful.[/INST]Hi... Thank you for consulting in Chat Doctor. 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. Hope my answer was helpful for you. I am happy to help any time. Further clarifications and consultations on Chat Doctor are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.</s>

<s>[INST]6 year old male diagnosed with high lead levels. has been treated with chelation intramuscularly and then with the medication given by mouth. level receded to high normal level for one month. current blood test shows a significant elevation and the chelation medication is to be started again this evening. are there any other suggestions that you can make as far as treatment to permanently diminish this problem to a safe level. surroundings, toys, etc. have all been tested and show no lead content that is harmful.[/INST]Thanks for your query on ChatDoctorFrom history its seems this child is having chronic lead exposure and lead toxicity. Its treatment include 1. Identification of source of exposure. It may be due to eating soil, paint, some herbal remedies etc.2. Behavioral modification to reduce non-nutritive eating habits.3. Dietary counselings to insure sufficient intake of essential elements calcium and iron.4. Chelation therapy to decrease lead level Hope this information will help. For more queries you may contact me at this site. Regards- Chat Doctor. </s>

<s>[INST]Does an ECG show up any potential heart problems. I had one last week for ectopic beats Ive been getting as a part of anxiety and it came back normal. I have had 3 in the last 8 years all normal. I had a weird sensation in my chest almost like my heart bubbled or flip flopped whilst I was vivid dreaming. Wondering whether I should be comforted by the recent ecg and its scaring me and making my anxiety worse.[/INST]ECG is the representation of your heart activity for that 30 seconds. Like all test it helps us detect many problems of your heart, however like other test It's not always true. If at all you want to investigate for ectopic beats consider below. I'd the symptoms do occur every day, get a 24 hour holder. If they are very rare once in a month or so and troublesome, an event recorder is a better investigation . Before you embark of such a tedious job let me assure that 85% population has at some point of time in life ectopic s, however most 99% of there are benign and not relevant clinically, so you should be worried it there are no associated symptoms Regards </s>

<s>[INST]I have been using Tobi in my Nebulizer for months. One week on and one week off. The side effect I have noticed is that texture of my hair has changed and it is falling out a little each day. My hairdresser noticed how different my hair is. Is there anything I can do?[/INST]Hi,welcome to ChatDoctorTobramycin is an aminoglycoside antibiotics which is used to combat infection....though textural change is not a well known side effect of the Chat Doctor. . Take a protein rich diet and eat fruits and veges rich in all the vitamin and minerals... Exercise daily... Do frequent hair massage with tips of your fingers with lukewarm olive and coconut oil in equal proportion,this will increase the circulation of scalp and improve the texture of hairs too... Conditioning of hair is a must think after wash... You can opt for hair spas or use fenugreek hair mask to combat hairless... Hope this will help you.</s>

<s>[INST]Hi, My mom had grade II breast cancer and every thing is completed including chemo and radiotherapy. Now she is having vitamin D deficiency. Doctor is recommending vit D injections. Is it okay to take those injections because i heard injections are painful and have side effects apart from its cost.Thank you[/INST]Hi, dairy have gone through your question. I can understand your concern. She had breast cancer. She completed the treatment. But if she has vitamin D deficiency then she should take vitamin D supplements. Because low level can lead to weakened bone. So go for vitamin D level once and then take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using Chat Doctor. Wish you a very good health.</s>

<s>[INST]I have an ALT (SGPT) of 61, but my other Lever function tests are within normal ranges. Should I be concerned, or is my old physician right that it is no big deal? He is significantly older and seeming dismissive in general since I don t look sick.[/INST]Thanks for posting your concern on Chat Doctor! I appreciate your concern towards the high ALT (SGPT) level. Age, gender, problem for which ALT is advised, and its duration, alcohol intake if any are not mentioned. Normal Adult Range for ALT : 0 - 48 U/Therefore, ALT in your case is slightly elevated. So, as your old physician suggested you need not have to worry about it. You need to have some lifestyle modifications to reduce the level of ALT. Daily physical exercise, eat healthy balanced diet preferably fresh fruits and vegetables which contain several anti-oxidants that help in reducing the ALT, AVOID ALCOHOL if any, avoid fatty vegan and non-vegan meals, fast junk foods, take plenty of oral fluids. INSA Allah, in due course of time your ALT will be normal. Wishing you best of your health.</s>

<s>[INST]I have sharp, excruciating pain in my lower left side of my mouth from a bad tooth. Its the 2nd one from the back. It has a cavity in it. I had tried various home remedies to be rid of it, and nothing works. My funds are all but nothing, so I am worried a dentist may not help me....What can I do?[/INST]Thanks for your query. I have gone through your query. The pain could be because of the infection in the root tip of the tooth. The home remedies will not help. We have to treat the cause by treating the tooth with root canal treatment or extraction. Consult your oral physician and get radiograph done and start with the treatment. You can take a course of antibiotics and analgesics like penicillin and diclofenac(if you are not allergic). I hope my answer will help you. Take care.</s>

<s>[INST]HI I have depression from last 5 year. I am not able to find a job for me. Whenever I feel that I should get a job and apply for it I feel stressed out and I never apply for it. I feel traped,low sad and in fear whenever I think of applying for a job and feel that its not possible for me to attend an interview. Also I have sleep problems. I hardly get any sleep at night. Its sleepless nights and in the early morning I get a sleep of 5-6 hours. For this I have consulted a doctor and he has given me depran forte at night and I am using it since last 3 years. I get sleep almost at 3a.m. at night and wake up at 12 a.m. In morning. I take medicine at night around 9 p.m. although I have taken this medicine for 3 years I have not been able to apply for job until now as I still feel fear and I feel I cannot do it. Why is that the case still when I am taking medicine from last 3 years. Help me on this please.[/INST]I guess the dose of medicine is not enough for you. I wonder why your doctor did not increase the dose. Also I prefer using Escitalopram and clonazepam as separate medicine not as combination like you are taking. Escitalopram is the main medicine which will help you to get rid of all depressive symptoms including decreased sleep, fatigue,low mood etc. clonazepam should be used for only initial phase of treatment when restoration of sleep and decreasing anxiety are preferred goals. Onces Escitalopram starts showing its effect. Clonazepam should be tapered and stopped. As long term use of clonazepam may decrease your thought process. Hope this would help you</s>

<s>[INST]I have a male friend who is 30 and has borderline personality disorder and borderline intellectual functioning who swallows spoons and pens when he is depressed, I m afriad that when he notices that I m concerned that I am reinforcing his self-multilating behavior can this be true?[/INST]Degree understand your concerns went through your details. I suggest you not to worry much. borderline personality disorder guys do not trust others. In this case, please stop watching him directly. He needs medical treatment immediately. If you require more of my help in this aspect, Please post a direct question to me in this website. Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques which should help you cure your condition further. Hope this answers your query. Available for further clarifications. Good luck.</s>

<s>[INST]A friends family dog bit my daughters top lip today. It bled for less than a minute. I immeadiatly applied pressure with an ice pack and applied antibiotic ointment. It doesnt look deep at all. Lip is swollen. Dog is up to date on all vaccinations and rabies. Should I do something else?[/INST]Hello, Welcome to Chat Doctor, Rabies is 100% fatal, but it is 100% preventable by proper and adequate treatment and this is transmitted by dog bite. As your daughter was bitten by a vaccinated dog over the lip which has led to bleeding from the site, according to WHO it is categorized into Cat III. Even it is a vaccinated dog you need to doubly check whether it is properly and completely vaccinated, because the bite is on the lip which is closer to the brain and the virus can ascend easily and reach the brain and can affect it. So I would suggest you to take 1. Active immunization with antirabies vaccine on days 0,3,7,14 and 28.2. Passive immunization with Rigs around the wound.3. Oral antibiotic like Tab Augmenting, twice daily4. Topical Tract ointment.Don't take any risk with this disease, I would suggest your daughter to take aforementioned treatment. Thank you.</s>

<s>[INST]Sir , i have a problum, i am 23 age young ,, i strated on masturbate up to 16 th age, now my masturbite timing maxmum 2 minuts ,so what i do sir , i want to increas timing sir bcoz i am getting married after few month ,i am worried about the sex may be wife cant satisfide my sex, so pleas advise me ..[/INST]Hi and welcome to Chat Doctor. Thank you for your query. I am Chat Doctor, I understand your concerns and I will try to help you as much as I can. Premature ejaculation is uncontrolled ejaculation either before or shortly after sexual penetration. It happens with minimal sexual stimulation and before the person wishes. Most cases of premature ejaculation do not have a clear cause. With sexual experience and age, men often learn to delay orgasm. Premature ejaculation may occur with a new partner. It may happen only in certain sexual situations or if it has been a long time since the last ejaculation. Psychological factors such as anxiety, guilt, or depression can also cause it. In some cases, it may be related to a medical cause such as hormonal problems, injury, or a side effect of certain medicines. I hope I have answered you query. If you have any further questions you can contact us in every time. Kindly regards. Wish you a good health.</s>

<s>[INST]I saw a white flake in my pubic area and there are a bunch of bumps around the base of my penis and all round my ball sack. My my ball sack is reddish pink skin. Every now and then i would need to itch and itch the area near my buttcrack. They were really white flakes, and I saw them near the tip of a few of my pubic hairs.Im just wondering could it be crabs, or lice, or scabies.[/INST]Hi, thank you for asking Chat Doctor. With this presentation, I think it is scabies. You may try Permethrin cream, lineage cream or benzyl benzoate solution. In addition to this treatment, you also need to some antihistamine for itches and sterilize your Chat Doctor. I hope that answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. We will be delighted to answer more questions from you. I wish you good health</s>

<s>[INST]Blood tests showing neutropenia and lymphopenia? Positive for Esptein-Barr virus at Igg but negative at Igm. Symptons started 6 months ago but just got blood tests back today, Symptons have included sore throat, reoccuring infections, body aches and pains, sharp pains in glands that come and go, headaches, dizzines, hot flushes, frequent urination, fatigue, uneasiness, anxiety. I have been on around 10 courses of anti biotics in last 6 months for different things. Sore inflamed throat and aches and pains constant with fever sensation over the last few months! Advice please? Vitamins not helping much! P.s Ct scan, Cardiac assement and cystoscopy all normal in last few months.[/INST]Hello dear thanks a lot for your question there is no specific medicine to treat Epstein-Barr Virus Infection. Some physicians use corticosteroids to treat significant swelling in the throat or an enlarged spleen, but steroids are not needed in most people. Antiviral medications are available to help oral hairy leukoplakia, including acyclovir Oral: 400 mg orally every 8 hours for 7 to 14 days(Viral), penciclovir (Cytosine), and scarlet (Oscar). Please you can meet your local Doctor for more on to use the Chat Doctor. </s>

<s>[INST]hi iam 18 year please tell me solution anyone cant tell me solutions i have pimples on my face that disturbed my life please tell me solution dont coment tell exat solution tablets,exercise, yoga ,pranayam,food also if possible tell solutions for ED and glow on face[/INST]Hello Shubham;welcome to ChatDoctorAcne are common for your age, and they increase with dirt;pollution, so first you need to clean your face with soap and water you can use Detail soap. Secondly you need to differentiate the pimples whether they are simple or big;pink and hard which are called acne rosette. If it is acne rosette then you can use ointment called Kremlin it is an ointment with antibiotic and will help treat it, but there is no complete cure as it will keep on coming till a certain age. As for food avoid excess oily and spicy food, and you should be fine. Thanks</s>

<s>[INST]Yes. Recently, Ive had 3 blood tests showing low WBCs and some other abnormal counts. I sometimes take pamabrom when I feel bloated. Could this cause leukopenia and neutropenia? Im also definitely iron-deficient/anemic and that is being treated. The low WBCs is still a mystery, though.[/INST]Hi, dear. I have gone through your question. I can understand your concern. There are many causes of low WBC count. Even simple viral infection, typhoid, malaria can lead to low WBC count. If you have any symptoms then consult your doctor and take treatment accordingly. If you don't have any symptoms then no need to worry at all. Your Chat Doctor. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using Chat Doctor. Wish you a very good health.</s>

<s>[INST]from usg report the liver appears enlarged measuring 154mm in mid clavicular line. evidence of a well defined hyperechoic SOL measuring 16.6mm in diameter in right lobe. intrahepatic billiary radicles are not dilated... the patient details... 71 years, female , height: 5ft. 6inches..... i just want to know details about the disease...whether it is malignant or it is curable....... tne way of treatment... please help me out to treat my mother......[/INST]Hello Enlarged liver(hepatomegaly) may be due to many reasons like hepatitis, fatty liver, tumour etc. Hepatomegaly is most likely related to mass(SOL) in your mothers case. SOL may be due to many reasons. It is due to both benign or malignant reasons. She may need few more investigations like routine hologram, random blood sugar, liver function test, renal function test, viral markers, contrast CT scan of abdomen. Contrast CT scan is most important, and it is very helpful in diagnosis and extent of lesion.FNAC/Biopsy can be done if needed. Treatment depend upon findings. Take Care Chat Doctor. </s>

<s>[INST]Hi doctor I have lost a stone in weight over the last month, last time I had any form of sex was around 8 months ago. Pregnancy test revealed i wasnt pregnant sfter doing snout 10 of them When I eat little my stomach feels full and is extremely bloated , constant aching stomach until I lay down. What could this possibly be[/INST]It sounds like stomach issue. All this is caused by high acid secretion which is found in gastritis, HERD or hiatus hernia. These disorders can cause such difficulties, and you should do gastrostomy to evaluate this. Symptoms that are experienced in such conditions are pain and tightness in upper stomach, bloating, breathing difficulties, heartburn, feeling of lump and sore in throat, gurgling sound in throat, fatigue and loss of appetite. Symptoms are aggravated after meal, long sitting, leaning forward, stress and anxiety. In the beginning this is treated by changing dietary habits. You should avoid alcohol, coffee,smoking, fats and fast food, carbonated Chat Doctor. 1 hour after meal you should not sit or lay. Also lay with elevated upper body. If you are overweight you should do often exercise if overweight. Wish you good health.</s>

<s>[INST]My mom recently fell hard, hit her head and received 2 staples. The CT head/brain without contrast reads...Moderate white matter hypodensities are seen in the deep, periventricular and subcortical white matter with volume loss and old lacunar type infarcts in the basal ganglia. There is mild global volume loss. Chronic microangiopathic changes in the old lacunar type infarcts and mild global volume loss.[/INST]Hello, In relation to the fall that she took the CT scan doesn't show any damage due to the hit, none of those findings are related to the trauma, they were already present before she fell and hit her head. The findings are due to chronic changes in the brain matter and its blood vessels. Chronic microangiopathic changes are changes to the small blood vessels. To a point, they are genetically determined and are found in many people as they age. They are accelerated by factors affecting blood vessels such as high blood pressure, diabetes, smoking, high cholesterol etcetera. So the only thing that can be done to slow down this process is checking for the presence of those factors and ad Chat Doctor. As for the mild volume loss that means the mild shrinking of the brain. Again that is part of aging, all of us start to lose brain cells after our thirties, so as we age volume loss accumulates. So that finding depends a little on her age which you do not mention, the older she is, the more such volume loss is expected. The report speaks of mild volume loss so no reason for major concern on that regard, the blood vessel changes which I add</s>

<s>[INST]hi, i have knee pain since november. it pains while sitting and standing but no pain during walking. ccp antibody test was positive(6u/ml).i ws prescribed winflam. is this medicine beneficial? i had pain in my fingers also but not on regular basis. the knee pain is continuous.[/INST]Hi, i appreciate your concern.it seems you are having arthritis affecting more of your patella femoral joint, where space is seems to be reduced, this is causing you pain while sitting and standing. Since u have not mentioned your age, still there seems to be possibility of ?OA, or crystal arthropathy.i arise my such patients to change in lifestyle for daily routine activities, do not sit on knee flexed fully, rather 90/90 position even in toilet also.nowadays good medicines are available for such problems without painkillers.be in touch your or tho expert.I will be happy to answer anymore ants.</s>

<s>[INST]I have been in extreme pain from a brachial plexus nerve avulsion C 7,8 ,T1,2 and spi.since 2003. The meds Ive been taking 3600 mg.Gab, 100 mg. Methadone, 40 mg. Baclofen and 30 mg. Cymbalta cover about 50% of the pain. My Pain Specialist has been pressuring me for years for a scs implant for years and I finally agreed, however I then find out I have to wait 1 year to see the Neurosurgeon. This is suppose to be the best pain clinic in Ontario St. Josephs Hospital London Ontario. Problem is all or most of the info from people on online forms who have spinal cord stimulator implants are not as positive as the Doctors. Do any Doctors available have any direct knowledge on this subject ?[/INST]Hi, Thank you for posting your query. It is unfortunate that you have been suffering from neuropathic pain for more than 10 years, and various pain medications have only partially helped you. I did not see pregabalin (lyrics) in your list of medications used. If that is the case, you can give pregabalin a try, as many people improve with that. Regarding spinal cord stimulator, it is an excellent option for pain control, however, just like other pain relief measures, it succeeds only in a proportion of patients. In the best pain centers, ACS implant may succeed in only about 60-70% of people. 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/</s>

<s>[INST]My husband had a ct of his chest and found there is calcified plaque within the thoracicaorta, proximal great vessels and coronary arteries, with ectasia of the ascending aorta to a diameter of 3.9 cm. Borderline enlarged mediastinal lymph nodes measure up to 11 mm short axis in the precarinal region. 10 mm short axis inferior the left mainstem bronchus and 11 mm posterior the right atrium. There is a lobulated masslike consolidation in the anterior right lung apex measuring up to 5.0X2.9X1.8 cm in maximal dimention. There is a 7mm subpleural lateral right middle lobe nodule and additional tiny subpleural nodule is present. Can you tell me what they are saying in laymen s terms?[/INST]Thanks for your question on Chat Doctor. I can understand your concern. I have gone through the CT report you have mentioned. This report suggests that your husband is having lung infection. He is having right upper zone consolidation (pneumonia). So give him antibiotics and get done repeat chest x-ray to rule see if this consolidation is improving or not. If it is improving then no need to worry. But if it is static or worsening then possibility of mass (cancerous) is more likely. Hope I have solved your query. I will be happy to help you further. Wishing good health to your husband. Thanks.</s>

<s>[INST]have a hard pea size lump at the very top of my left leg on the very outside of my body, any ideas? Possibly cold have bumped it in the past, its close to tensor fascise latae. I can only feel it when i am lay on my rightt hand side. An issue seeing a doctor is, im travelling around laos, vietnnam and southeast asia til october when i return to england, but i do have a good travel insurance, they may charge me as i could have had it previous to march when i first started travelling. A big thankyou for taking the time tto read my email.[/INST]HI, Dear,Thanks for your query to Chat Doctor virtual Clinic. I studied your query in all the details put forth by you. I understood your health concerns about the cause of hard pea sized lump on upper left side of leg. Cause of the hard lump on left top of leg-The facts of your query indicates that you had ?hit in the past to left knee, and it is felt only when on right side-these two facts indicate it to be left outer meniscal tear, which becomes prominent on right sideways position. As many other causes need to be ruled out by Second opinion from ER Ortho-Surgeon and hence your doctors second opinion is suggested. Hope this reply would satisfy your query and would resolve the worry with it. If you feel satisfied with this reply, dont forget to hit thanks and write excellent review comments, which would improve my rating for new needy visitors to Chat Doctor. Welcome for any further query in this regard to Chat Doctor. Have a good day. With Chat Doctor. N.M.S. Genl-CVTS, Senior Surgical Specialist</s>

<s>[INST]Sir my father got stroke a month back.His right side is paralysed,cant able to speak,having difficulty in understanding.From his behaviour we think there is loss in memory.Dr prescribed , Telday20,Avas 20,Diapride2mg,Clopitab75,meconerv plus.He is diabetic type2 . How can we improve his memory and speaking skill?[/INST]Hello! Welcome on Chat Doctor ! I understand your father clinical situation and agree with the medication prescribed by his doctor. Unfortunately there are not any specific Chat Doctor. But, I would recommend taking paracetamol or Catiline. Consulting with a logopedist for his speech disorder and performing a lot of physiotherapy for his limbs, is the main treatment in the next months, which will help improve his situation. Hope you will find this answer helpful! Best wishes, </s>

<s>[INST]My father just started having dialysis after his creatinine level reached 15.4. Since then he also found blood in his urine. The doctors did cystoscopy today and found a tumor present. They said that they had removed the tumor and sent for some examination. They also said that if everything goes well, he will not have to undergo dialysis. Is this possible??? Till today, he has got 5 dialysis done.[/INST]Hello and welcome to Chat Doctor, The need for dialysis depends on the clinical status of the patient and blood creatinine levels. Dialysis also depends on the underlying cause of raised creatinine levels. If the creatinine was high due to obstruction caused by bladder tumor, removal of tumor will reduce the creatinine levels. However, if the high creatinine level was due to primary kidney disease, the status of the kidneys has to be assessed to know the requirement of dialysis. Thanks and take care Chat Doctor. </s>

<s>[INST]I am a female of 49 years. Suddenly my front portion of throat have swollen with a lump (approx 15cm radius) and on one side of the neck. Doctor advised me certain blood and other tests to test forThyroid diseases. But reports came normal. This symtom has developed for the last three days. What could be the disease? I am on medicine for Arthritis for 10 years and have no major problems. Please help.[/INST]Hi! Good morning. I am Chat Doctor answering your query. Even though your thyroid blood reports are within normal limits, still the swelling could be related to thyroid apart from other swellings of the neck. However, it might not be possible to diagnose the lump without a clinical examination, and a confirmatory test like an FNAC/core biopsy along with an ultrasound of the lump. 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. I wish you an early recovery. Chat Doctor.</s>

<s>[INST]Hi, my brother has dengue and his platelets count went on 93K when he was admitted. Next day count raised to 1.6K but now it has come to 43K on third day. Do I have to worry as he is hospitalised and seems doctors are not taking it serious. Please advice.[/INST]Hi, Sorry to hear about your brother and also appreciate your concern. The number of platelet count in dengue is of prognostic value;it means that it tells us how the disease is progressing and if platelet count has come down to 43K from 1.6K in one day, it should be followed up keenly although in my opinion a retest is a must. If it goes down further, he may need platelet infusion. Please talk to the doctor and keep an eye over the platelet count and the overall condition of your brother. I hope this answers your question. Please feel free to ask another question if there is another query. Thanks, Chat Doctor. </s>

<s>[INST]Hi there, I had an abscess drained about four weeks ago and my wound was packed. Have seen the nurse every few days and have been advised wound is fine and has healed. However since Saturday I have a hard lump attached to my scrotum and it is the same as previously had before drained. Can you advise what I should do? Is this normal for abscesses to come back so soon?[/INST]Thank you for your query. You are probably suffering from Sebaceous cyst of scrotum, which are getting secondarily infected, resulting in abscess formation. The infected ones are operated, as because they are multiple, and the symptomatic ones are left alone. Hot fomentation, local antibiotic ointment application and oral penicillin are the main stay of treatment. Please do also check your blood sugar levels, and ensure that you maintain personal hygiene. Take care and get well soon.</s>

<s>[INST]im 41 had two ablations for afib been normal rate for almost two years.have had several test on gastro side normal with gerd they say but lately have pains in left arm and chest that comes and goes with head aches bad sometimes pains last mins to hours my heart rate at rest is 65 blood pressure 137/81[/INST]Thanks for your question on Chat Doctor. I can understand your concern. Your blood pressure and heart rate are normal, but since you are having history of atrial fibrillation and ablation, better to first rule out coronary artery disease as a cause for your left arm and Chest pain. So first get done 2d echo, stress test (trade mill test) and coronary angiography (if required). If all these are normal then no need to worry about heart diseases. Musculoskeletal pain can also cause similar symptoms. So avoid heavyweight lifting and strenuous exercise. Take painkiller and muscle relaxant Chat Doctor. Apply warm water pad on affected areas. Don't worry, you will be alright. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.</s>

<s>[INST]I am 58 year old, suffering from persistant cough for last three months, x ray shows a triangular opaque shadow in mid lung right side which is persistant for three months. Treatment taken,culture is negative, bronchoscopy normal tb tests normal advise further way[/INST]Thanks for your question on Chat Doctor. I can understand your concern. Persistent shadow on chest x-ray despite taking treatment suggest possibility of lung cancer. Bronchoscopy and culture are negative for infection like TB. So better to get done CENT thorax (CT scan with contrast). If this shows mass lesion then CT guided biopsy from the mass is needed forecourt diagnosis. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.</s>

<s>[INST]My daughter is 5 years old, she has never had this issue before but for the last 4 days when she wakes up in the morning as she is eating breakfast she throws up. After she throws up she will continue eating and will be fine for the rest of the day until the next morning. I dont know why this is happening, she is not running a fever nor is she complaining of stomach pains.[/INST]Our stomach secretes acid which helps in digestion. It is secreted throughout the day. Throughout the night, the acid gets collected. This acid irritates the inner lining of the stomach. So, in the morning when your child takes in the food, the already irritated gastric wall revolts, and she vomits out the contents of her breakfast. But in the process of digesting the breakfast, the gastric acid becomes utilized and such a situation does not arise till next morning. Hence, she remains fine throughout the day.</s>

<s>[INST]I have been drinking several red bulls. Was recently told I had a heart murmor. Somtimes my eyes burn.also I have had very frequent uti since drinking them. Basicly I have realized I need to stop. Also having high blooid pressure. Will every thing return to normal if I do and the murmor I never had go away? I am 47[/INST]Hi There After going through your query I Understand stand your concern. I would like to tell you that Red Bull contains Caffeine and excessive use of caffeine leads to high blood pressure and high Blood pressure can cause LV dilation or LV failure which results as a murmur.It's advisable to limit use of Caffeine n Caffeine containing products and personally consult a Cardiologist to evaluate the reason or Murmur. Get one ECG and an echocardiography done and see a cardiologist with reports for proper treatment of High BP and murmur. Hopefully this will answer your query. Kind Regards Chat Doctor. </s>

<s>[INST]went to the ER with severe abdominal pain just below the sternum. Fells like theres something stuck there. They ran x-ray and ultrasound and found nothing. No gall baldder or ruptures. Im still in lot of pain as before and constantly feel like i need to use the bathroom for #2 but nothing. please help.[/INST]HI. Read the history carefully. There is a possibility of colitis and/ or enteritis. X-ray and ultrasound may not detect such problems at all. I would advise you to undergo upper GI endoscopy and colonoscopy if medical treatment does not help you. You may need an antibiotic and metronidazole and Sanitizing and supportive treatment to get a relief and cure. Use antispasmodic tablets to get a relief of pain</s>

<s>[INST]I have a lump on my leg and the doctor just told me its was a gland with fluid in it and right above it was another gland and the gland that was bigger seems like its got smaller and the one above it seems like it has gotten bigger. Could the fluid just be draining up to the other glad or should I go back to the doctors?p.s. it sort of hurts[/INST]Hi, Dear,Welcome with your query to Chat Doctor. Studied your query in full depth of its details. Reviewed it in context of your health concerns. Based On the facts, You mostly seem to suffer from-Varicose Veins with perforator Vein Lumps, which hurt a bit.or/ this could be Sebaceous Cysts caused due to the blocked sebaceous glands in the hair follicles. Other causes need to be ruled by Second opinion from a Surgeon or Dermatologists. Hope that, This reply would help you to plan further treatment soon with your treating doctors. Best of Luck and early recovery. Welcome any further query in this regard, which would be replied in next session. Good Day!! Chat Doctor. N. Senior Surgical Specialist</s>

<s>[INST]For the last year I have been having WBC with diff done every 3 months due to a high WBC of 19,000. This count has fluctuated throughout the year, but never been normal, also no illness to account for. I do have symptoms of fatigue, petechiae (hands, arms, and chest-occasionally), HTN, and some diarrhea. EKG from 5 years ago normal, LFT normal, CMP normal, Rheumatoid normal, kidneys normal. Been to an allergist and told I do have even more allergies, but would not account for the high WBC. Sed rate slightly elevated. Please advise. Jen[/INST]Hi and thanks for the question, Chronic elevation of the ABCs deserves a more critical evaluation. In your case especially, the association with increased ESR, fatigue and petechial suggest exclusion of a bone marrow malignancy, especially a leukemia. A bone marrow biopsy might be compelling. Secondly, I would to suggest carrying out Anti-nuclear antibodies, HLA27 and autism antibodies for your symptoms are also very compatible with systemic lupus erythematous, which is an autoimmune disease. The symptoms as I said are very suggestive of a leukemia. An appropriate diagnosis is critical, for the setting up of an appropriate treatment plan. Delayed diagnoses my make the prognosis more faint. I suggest you book an appointment with the hematologist, to rule out a leukemia or any possible blood malignancy, and possibly systemic lupus erythematous. Thanks for your question and hope this helps, Luchuo, MD.</s>

<s>[INST]I was born White(Wheatish brown).Now I have become brown in Complexion.This Happened for Lots of Reasons.How can i Get back Fairer as I was??.Suggest Home Remedies..Thank you!![/INST]Welcome to Chat Doctor You need t apply sunscreen lotion of SPF 25 at least for protection from UV rays from sun. Try to avoid sun exposure. Use colored umbrellas for protection from sun. Eat fresh fruits and vegetables every day as they have antioxidants and vitamins that prevent damage to skin. Chat Doctor. Exercise every day for 40 minutes by brisk walking which is enough to improve blood circulation to skin and make it glow. If you have any pigmentation on your face that can be removed by many methods like bleaching creams, laser etc. Consult your Dermatologist to get further information.</s>

<s>[INST]i just found a lump in my groin area its very close to the inner leg joint so im not sure if it is a normal part of the body as i have another lump on the other side on the exact same spot but it is a little smaller. you have to push deep to find it and moves around freely esp when walking thankyou[/INST]Hi, Welcome. Based on the facts of your query-You seem to have normal lymph glands in the groin. And they become specially felt while walking. Hope this would help you to plan further treatment with your doctor. Will appreciate your Hitting thanks and writing excellent review comments to help needy patients like you. Welcome with any other further query in this regard. Good Day!! Chat Doctor. S. Genl-CVTS</s>

<s>[INST]My name is Tamara. I am a 32 year old white female with class V membraneous lupus nephritis. I also have multiple comorbidities including compartment syndrome in my lower extremeties with gross edema. Recently, I have had boughts of severe swelling that results in massive water retention, to the extent of 40 pounds gained in less than a month. While kidney function is fine during this increase and I can eventually pull off the fluid with crazy diuretic therapy, after the output, it seems that all of my muscles from mid calf to ankle are now hardened and very tender to touch. I have waited several weeks in the hopes that the tissue would return to normal, but no avail. What could have caused this, what condition is this called, and is there any way to reverse this as it is very painful (I doubt there is in my experience *I am an RN whos specialty is Renal Transplant/Nephrology* ). Any information regarding this would be very much appreciated so that I can continue on this side. That you! Tamara.[/INST]Hi, Thank you for choosing Chat Doctor, Look mam you have pretty tough condition in the sense of medical ground, in my opinion such case needs team work, this could be chronic nephritis, I personally ask lots of investigations to come online of treatment and to know the prognosis, without this, it is not possible to come on any decision, you batter have words with your treating Doctor, meanwhile cut down the salt,take care of your self, Have nice day</s>

<s>[INST]Dr. Mild pain started below neck on C6/C7 a week ago. While I applied some ointment or Motrin it is subsided, yet reappeared after a day or day. I feel pain when I touch on the upper exterior of C6/ C7. However, I have no shooting pains on my hands or elsewhere. My routine is not affected that includes my daily exercises and walking. I can turn my head/neck at all directions without any pain. Nevertheless, while I stretch my right hand in particular to pick things in front of me, I feel dull pain at the side of C6/C7area especially to its right . I am not diabetic, my BP is between 70/110 - 120/80 all through. My weight is 147 Pounds and height is 171 CMS. What is your advise doctor. Well, I may consult a orthopedic in this regard[/INST]Hi, Thanks for your query. The herniated discs compress spinal nerves or spinal cord. Symptoms are experienced along the area of distribution/path of that particular nerve. This has happened at level of C6-C7 in your case. Treatment includes 1. Use of cervical collar helps in immobilization and brings relief. 2. Medical Chat Doctor. 3. Methylcobalamin supplements are also recommended for nerve compression symptoms.4. Cervical isometric exercises are beneficial to maintain the strength of the neck muscles. Neck and upper back stretching exercises, as well as light aerobic activities, also are recommended under the guidance of a physical therapist. 5. Hot fomentation helps in relieving acute symptoms. I do hope that you have found something helpful, and I will be glad to answer any further query. Take care</s>

<s>[INST]Dear Sir,I am 23. I am feeling pain in my stomach (left side) since last couple of days. Pain is not more but light. I would like to share hat days back around 2008 i had a pain in my stomach and i checked it and found Appendicitis. it was small in size around.2mm so doctor recommend me to take injection. I took that and felt relax. Now i am feeling same problem. so please recommend me that what to do now?i am quite afraid that whether i got that problem again?what is the probability of severity on this??I ll be grateful if you will give me some solution on that.Best RegardsDharmendra Tripathy[/INST]Hi Carmen Chat Doctor. It looks that you have got colitis. A proper history, clinical examination, investigations as per these findings alone can lead to a proper diagnosis. This is most important to lead to a proper management/ treatment. So visit a Doctor, preferably general surgeon. All you need is a 5-day course of antibiotic, metronidazole and supportive medicines, and you will be fine. Do not panic and do not think this as a serious problem.</s>

<s>[INST]Thanks. I have had knee pain for about 2 months now. No blood clots found and no broken bones. After about a month of the knee pain I noticed a lump on the top left of my knee (left knee). The lump is soft and does not hurt to touch. Please help. What is goin on with me?[/INST]Hi! Thanks for sharing your health problem with Chat Doctor! After going through your problem of knee pain with lump on the top, I would like to consider following possibilities AS PER MY ROUTINE CLINICAL EXPERIENCE:1. Benign cystic conditions like bursa, ganglion cyst etc. possibility 60% 2. Inflammatory like synovitis, synovial herniation, patellar dislocation, synovial effusion etc., possibility 20%3. Benign solid tumor or tumor-like conditions like giant cell tumor, lipoma, neurofibroma, dermatofibroma, cysts possibility 20%Therefore, it could be a cause for worries in the future!. And you must confirm the diagnosis by ultrasonography and needle biopsy as advised by your doctor and thereafter discuss with him the possible treatment options.</s>

<s>[INST]hi my name is juliaI have 2.5 yrs old boy he had temperature at 7pm 101.4f. I gave him 4cc chilren tylenolthen I gave him another dose at 9.15pm 4cc his temperature droped to96.7f and last one at12 midnight and his temp now is 96.4 ist ok he had a case of ceasure at age 1[/INST]You can safely use Tylenol in the prescribed dose 4-5 times a day for a child who is running fever. However, it seems that you are using it even when there is no fever. Stop using it by the clock, and use it only if there is fever above 99.5 degrees F. Why did the fever occur? Most likely a virus, but it is safer to go to his pediatrician in routine hours within a day if possible. Use sponging as a tool to reduce fever - as your child had a fit in the past, don't allow the fever to rise beyond 100 F. I hope that helps. Best wishes.</s>

<s>[INST]Hello, my grandma is 71 turning 72 in July. She is basically in the end stages of liver failure. She had a tube that was drain excess fluid but she pulled it out because she was frustrated. Now she has a chest tube that is draining all the fluid because her lung collapsed. Her voice was going away for the past couple days but now it is completely gone. Is this associated with the liver failure or is there another explaination?[/INST]Welcome at Chat Doctor !! I have gone through your case and being your physician I completely understand. Your health concerns... Based upon the history you have provided it is rather difficult to pinpoint the diagnosis since your grandma has the variety of issues. End stage liver disease do presents with loss of speech that is called HEPATIC ENCEPHALOPATHY grade 4...... It is the most common cause of loss of speech in chronic liver disease. Second probability is hypoxia leading to carbon dioxide retention leading to acid base imbalance that too provokes hepatic encephalopathy and also one of cause of loss of speech. You better take her to hospital so that appropriate workup has been done, and proper management should be provided to her. May she get well soon, if u still have any query feel free to ask anytime regards Chat Doctor. </s>

<s>[INST]sir, fifteen dayes back i felt pain above right testicle. on ultrasound found.my prostate is 24grms and post void urine is 140cc.feeling burning sensation in urinary passage. my age is 64years.whether i have to go for long treatment or for a short period.height-5ft-6inch,weight-79kg,diabetic-but controled by diet.[/INST]Hi thanks for contacting Chat Doctor. Here you are having high post Vidal residual urine... Here according to report it could be prostate enlargement with infection.... You have to consult surgeon for per rectal prostate palpation and subsequent investigation. Urine also should be examined which will mostly will show presence of pus cells ... For infection antibiotic given with more fruit juice and more water..... After controlling infection if prostatic enlargement there biopsy or PSA done to reveal nature of prostatmegaly... Then accordingly treated like with that of tamsulosin or prancing... Consult surgeon for proper examination and treatment. Take care ....</s>

<s>[INST]I have sharp stabbing pain in my upper left abdomen. It started Sunday night, I was uncomfortable no matter how I laid in bed Sunday night but the best was to lay on left side on a heating pad. Yesterday during day the pain was not nearly as bad while I was working but started up again after I ate dinner and has not ceased since.[/INST]Hello dear , welcome to Chat Doctor.come have evaluated your query thoroughly.* There are different possibilities for this pain in left upper abdomen as @ Abdominal wall related as muscular. @ Intro abdominal left Hyperion Chat Doctor. @ Diaphragm related. @ Left lung lower lobe pathology as pneumonia, effusion or other. @ Referred from kidney as calculus or other. Hope this will help you for sure. Wishing you fine recovery. Regards dear take care.</s>

<s>[INST]hi my name is ravi, i am 26 suffering from high SGPT since last four years, having treatment also, its ayurvedic treatment, but after having all sort of precautions also the results are unfavourable, as in am monitoring it for couple of weeks, the 1st week the result was 102, 2nd week it was 72 bbut the third week again it was 92.... i am very much worried as my job also depends on it, i am in merchant navy[/INST]Hi welcome to the Chat Doctor I need to know cause for elevated Sept level Don't try any self-medication for your condition Your following report should be done.... _USG abdomen _serum bilirubin estimation _Bag ELISA _CV ELISA _Serum cholesterol If you are having fatty liver or non-alcoholic steatohepatitis then Adílio can be prescribed, and low fat diet consumed So depending on because I can give further comment Hope your concern solved Take care</s>

<s>[INST]Hi! I have extremely dry skin where my two butt cheeks meet, like in the crack of my butt. It itches terribly, and often leaves a burn of flakey dry skin in my underwear. I know that I have psoriasis on my scalp. I was just wondering if it can affect my butt cheeks and also my genital area? I ve had vaginal itch since I was young. Yeast infection medicines dont work, rarely will an anti-itch cream work. It was localized on one side of my vagina for 10 years and had since spread to both sides. My family doctor just says to use anti-itch, but I think there s a bigger issue or a better answer. The left (original) side had turned a darker color and is thicker. What exactly could be the issue?[/INST]Hello and welcome to Chat Doctor Psoriasis is a likely possibility as it can very well involve the body folds. Psoriasis classically involves the extensors like scalp, elbows, knee, shins and lower back, but sites like maxilla, groin folds can also be involved either together with the extensors or solely, where it is classically known as inverse psoriasis would advise that you see a dermatologist for a confirmatory diagnosis. Psoriasis in the body folds responds very well to topical steroids as well as topical immunomodulators like tacrolimus/pimecrolimus ointment. An OTC antihistamine once daily e.g. cetirizine would help you symptomatically with the itch. Regards</s>

<s>[INST]I have a slightly elevated liver enzymes, very low vitamin d. My thyroid checks out fine. im fatigued, hair loss, dry skin. I also had a vaginal biopsy and they found hyperplasia . Is the liver enzymes and low vitamin d related. the doctor said not to worry about the liver enzymes. she put me on 50,000 units of vitamin d.[/INST]Hi, Thanks for writing in. Liver enzymes might be elevated due to disease and this can lead to reduced synthesis of vitamin D. It will help to know by how much your liver enzymes are raised and then treat any condition that is causing it. Since the doctor has told not to worry therefore I think the liver enzymes are not very high to cause a concern. However, you might have vitamin D deficiency and this requires you to take supplement. The pap smear showing hyperplasia requires discussion with the pathologist. Hyperplasia itself does not indicate cancer but might be a precancerous stage. You might vitamin D for now. Please do not worry.</s>

<s>[INST]I have a sore lump (quarter size) on my lower, inside arm and I noticed it 4 days ago. It s getting no bigger but still sore. Should I wait a week after applying ice and taking anti-inflammatory to see if it goes away. It s mid way, between elbow and wrist on inside of arm. I may of hurt it but don t remember doing it.[/INST]Hi, dairy have gone through your question. I can understand your concern. You may have some benign cyst like Desmond cyst. Or you may have some soft tissue tumor like lipoma or neurofibroma. You should dot wait because it doesn't look like inflammatory lesion. You should go for fine needle aspiration cytology of that lump. 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 Chat Doctor. Wish you a very good health.</s>

<s>[INST]Hi I am 30 yrs old and my husband is 33. We are planning for a baby since 2.5 yrs . In Oct 2010 we got to know that i am having a cyst which was constantly present for 8-9 mionths and our gyn said that it might be a chocolate cyst and endo. So we had laproscopy done in Sep 2011 and after that tried for iui for 5 months but unsuccessful. Then our gyn said to go for IVF wherein we still are thinking as it is very expensive. We went to another doctor in March 2012 and she prescribed Lupron depot inj for 3 mths and I got my mensus in Aug 2012..I want to know what are the chances to conceive with endo and should i wait for sometime and try iui or what else can be done..please help..Regards Neha[/INST]Hi, As you have already tried 5 cycles of GUI after laparoscopy, it's better to try for treatment which gives better pregnancy rate which is IVF. As you have already received In Lu pron Depot for 3 months, it would have been better to go for IVF immediately after 3rd dose of Lu pron as it increases chances of pregnancy in IVF. But still It's not too late. You can go for IVF straightforwards or can again take Lu pron depot for 1-2 months & then go for IVF. IVF is definitely the best treatment for you. Wish you good health.</s>

<s>[INST]I have had a very bad cough of an on since Sept. It just recently got bad about a month ago. My Dr has been treating me for pnemonia and I have been on 5 rounds of antibiotics a shot of one and Im on my 3 rd round of steriods. I also got a shot of one in the office yesterday. My symptoms are getting worse and I started to have a sore throat n swelling of my face within the last 3 hours. Im wheezing really bad and my bp is 138/86 and pulse is 98 should I go to the er? I am very scared n shaking. I have had xray of chest and than yesterday a Cyst scan with contrast of my chest. I am very concerned and am just getting worse[/INST]Hi, Dear,Thanks for your query to Chat Doctor. Dear I read your query and reviewed it with context to your query facts. I understood your health concerns and feel Concerned about them. Based on the facts of your query, you seem to suffer from-Steroid Induced Facial Swelling with Asthma. Remedy-Recheck with your Doctor and review the steroid doses. More info on antibiotics for Pneumonia is needed to suggest on your current health issue of sore throat/ swelling and wheezing. More info on Cyst Scan is required to know why steroids are used in Pneumonia with 5 rounds.And to your query on ER visit? Yes, you should visit ER and check up for various possible causes for such a complaint, witChatDoctorplicated illness over last 1 month. Hope this would help you to solve your health issues in the best way possible. Welcome for any further query in this regard. Good Day!! Chat Doctor. N. Senior Surgical Specialist. S. Genl-CVTS</s>

<s>[INST]my mom s blood pressure over the last hour has been very low, mostly the bottom number. the last reading was 145 over 64 but was as low as 51 on the bottom number. her question is should she take her blood pressure medicine as normal. She s kinda worried it may make it drop in the night too low.[/INST]Hi Welcome to Chat Doctor. I understand your query and concern. Yes she certainly needs to continue her blood pressure medications. Low number of the denominator need not be worry at the moment. All she need is good HY Chat Doctor. Reduction of daily salt intake to less than 6 gm/day will help. Monitor the blood pressure daily over 2 weeks to adjust adequate dosage. I advise you to have a baseline 2D echo and ECG on semi-annual basis for better cardiac assessment. Consult an expert cardiologist for further help. Post your further queries if any. Thank you.</s>

<s>[INST]I have been experiencing cold rushes down my left leg from time to time. I do have five hyrneated discs in my lowerback for over forty years. When that happens my leg sometimes goes numb briefly, nothing has to be going on at the time that happens. I had hip surgery on my right hip three years ago with a replacement hip. The problem with my leg is with my left leg and started after the surgery. It causes no discomfort at this time but, Im just wandering if this is a precusor to what may be to come.I am a sixty- six year old woman, retired and in fairly good health. I am a make up of many cultures.and tat[/INST]Hi, thanks for writing to Chat Doctor. Your problem in the left leg is no way related to your Hip replacement surgery of the right hip. As per the description, all your symptoms suggest a degenerative disc disease of the lumbar spine witChatDoctorpression of the neural elements. The conservative management of degenerative disc disease is as follows -* avoid lifting heavy weights as it imparts more strain on your back* avoid forward bending activities as it will worsen the disc protrusion* Use a lumbosacral back support to augment your spinal muscles* Intermittent pelvic traction to cause a regression of disc* Maintain optimum body weight, if you are obese* Physiotherapy to strengthen your back muscles. Physiotherapy has to be done only after the acute pain has subsided.* Judicious use of analgesics and muscle relaxants. If all these measures fail to provide you relief, then surgical decompression may be an option. Hope this information is helpful. Good day</s>

<s>[INST]hi. i m 26. for past few days my mouth is notopening fully. i had pain in my gums n look like dey r swollen. may b wisdom tooth is formating. i dont consume tobacco or smoke . n it all started after i start dieting . i eat less than before. i also take herbal pills of active fibre. i just want to know what is wrong with me[/INST]Hello Welcome to Chat Doctor I went through your history & it suggests that you are suffering from Peritonitis i.e. inflammation of periodontal tissue before eruption of third molar. It occurs due to food lodgment & bacterial accumulation in that area. Its Symptoms are:- -pain -swelling -difficulty in mouth opening -fever -malaise -regional lymphadenopathy Get an IOP AR done & consult your dentist. If flap is interrupting in its path then go for flap removal i.e. operculumectomy. Otherwise, if sufficient space is not available then go for extraction since it is vestigial & has no role in mastication. For temporarily relief do warm saline rinses 3-4 times a day. Start with Tab Amclaid-625 twice a day along with Tab Aerosol -SP thrice a day for 5 days. In Case of gastric problem take rabeprazole-40 mg once daily. Your herbal pills won't be of much use. Do Betadine gargles twice a day. Take Care Regards Chat Doctor. </s>

<s>[INST]I have been a ocd sufferer for over a decade now i did not know of it for many years but later on underwent therpy for close to 2 yrs i was prescribed F-tin along with certain occupational therapies And it helped to certain extent but came a time when i realised that no pill is cut out for my specific forms of symptoms & i stopped Now the prolem is that though i am aware of my problems but can not help much Actually its hampering my studies by making my productivity low I have been trying a lot but pl tell what should i do as per your insight[/INST]Hi, I can understand your distress and concern, specifically since you are able to attain much benefit with treatment. OCD can be occasionally difficult to treat, but with right approach, can be dealt with effectively. Had I been your treating psychiatrist, I would have considered treatment with medications from selective serotonin reuptake inhibitors (SSRIs) like fluoxetine or sertraline together with behavior therapy in form of exposure and response prevention. Depending on the initial response to the 1st medicine tried, further course like adding clomipramine or an atypical antipsychotic like risperidone, etc. can be tried. You can discuss regarding these option with your psychiatrist. I am sure that with adequate treatment, you will respond well and get better. I do hope that I was able to answer your query. Best wishes for a speedy recovery.</s>

<s>[INST]Hello... iv rashes on my face n neck almost 5 days now, and its really itchy. My eyes are swollen. I ve done blood for lft n blood for r/examination,all are normal.my doctor prescribe ursokem-plus n litina- a Bt still no improvement..so please help me what really is it[/INST]Hi, Are you applying any over the counter face cream? Steroid containing over the counter creams may cause redness and rashes on face. Allergic reaction to hair also may present with swollen eyes. Superficial bacterial infection of skin such as erysipelas can also cause similar rash. So, I request you consult your Dermatologist for arriving at a final diagnosis and for initiating the treatment. Hope I have answered your query. Let me know if I can assist you further.</s>

<s>[INST]So my boyfriend and I were messing around. We had a condom on, and I was on top (Sorry for information ). However, he had already ejaculated... he still had that condom on while I was on top on of him. There was No penetration throughout everything . I was just like rubing the outside of my vagina on his penis ... now my period is late. Almost a week.... Could I be pregnant? Please help...[/INST]Hello dairy understand your concerned have non-penetrative sex and used condoms rubbing of the penis with condom on it does not cause pregnancy. To become pregnancy penetrative unprotected sexual intercourse in the fertile phase of the period is required. So there is no chance of the pregnancy. Your period can be delayed due to hormonal imbalance, ovarian dysfunction, excessive stress, change in lifestyle and dietary habitat for the period for next 4-6 days. If period will not come then consult the gynecologist and period can be induced by the progesterone pillMeanwhile avoid stress, take healthy diet, Chat Doctor. </s>

<s>[INST]42 yr old, female, Wt= 57 kg, Ht= 5.18 ft no positive past medical history used to wear shirts tight in axilla for a while just a couple of years ago, I have got hyperpigmentation on anterior border of my axillae, I use alcohol free roll on or spray. How can I treat my Axillary hyperpigmentation?[/INST]Hi............. axillary hyperpigmentation can occur due to friction with tight clothing(as mentioned by you)Even the use of deodorants and antiperspirants can cause it waxing.shaving, or hair removal creams can cause IIT can be post inflammatory after a bacterial or a fungal infection To treat this peeling- TCA peels or glycol or mixed peels can be done apply segmenting creams like comic acid or glycolic acid or HY Chat Doctor. Deodourants and sprays should be avoided.</s>

<s>[INST]My husband is 36 years old.he smokes 4, 5 times a day.his sperm count is 100 percent but his sperm motility rate is 50 percent only.is this motility rate okay?we have not been able to conceive for the last one year.my all reports are fine.Mona Sharma age-32 years[/INST]Hi, Normal sperm motility is considered to be greater than 50 percent. When the motility falls between 25-50 percent on a single ejaculate, this may not reflect a real problem. When the motility consistently falls below 25 percent, the chances of a problem are much higher. When the motility consistently falls below five to 10 percent, the chances that fertility is normal is highly unlikely. However, you should not worry as your husband has sperm motility of 50 percent which can be taken as normal.</s>

<s>[INST]My father had right sided Brain hemorrhage and was operated for SDH and ICH because of fatal road accident. He is taking Leviteracetam since that accident and at present he is recovered well except some problems with memory. He is having some hallucinations and psychiatric behaviour, does leviteracetam causes such side effects?? In our last meeting with the neurologist, he had started Oxcarbamazepine. Current Medications : Leviteracetam 500 mg BID Oxacarbamazepine[/INST]Hello, I have gone through your query and understand your concern. It is very difficult to predict these symptoms like memory loss, hallucination and psychiatric behavior whether due to Hemorrhage or Levitaracetam.A few people who take Leviteracetam for any condition (may experience depression, suicidal thoughts/attempts, or other mental/mood problems. Brain hemorrhage also cause the similar symptoms even after recovery. In brain hemorrhage, the complete recovery is very rare, and the patient may have symptoms occasionally or regularly.Thus, to find the cause thorough neurological examination is vital. If the neurological examination is normal, then switch over to other Chat Doctor. Hope this helps. Please write back for further queries. Wishing you good health.</s>

<s>[INST]I have a painful lump on the right side on my buttocks just inside the crack. I ve had it once before and used iodine on it to help it go away. Surgery is not an option for me as I do not have insurance. What exactly can I do to get rid of it. I cannot function like this?[/INST]Hi, dairy have gone through your question. I can understand your concern. You may have some perianal abscess or fistula. You should go for examination. If abscess is there then go for incision and Chat Doctor. If fistula or piles are there then it needs surgery. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using Chat Doctor. Wish you a very good health.</s>

<s>[INST]Hello Doctor My child having 3years suffering from frequent fever from 15 days due to swollen glands on the neck .our doctor prescribed us delcon plus , new deletusP syrups and nutocef50 tablets ...is this a proper prescription even though he is getting fever for every six hours severely..please prescribe proper medicine. Thank-you Swaroopa.[/INST]Hi... Recurrent fever with swollen glands in the neck for the past 15 days could be ABV infection or otherwise called infectious mononucleosis. It is a self limiting prolonged viral illness. Rarely it can cause complications. I will suggest you how a viral illness behaves so that you will be more confident. Fever of few days without any localizing signs could as well a viral illness. Usually rather than fever, what is more important is the activity of the child, in between 2 fever episodes on the same day. If the kid is active and playing around when there is no fever, it is probably viral illness and it doesn't require antibiotics at all. Once viral fever comes it will there for 4-7 days. So do not worry about duration if the kid is active. Regards - </s>

<s>[INST]I am 34 years old I have a acidity problem for last 6 years I have used lot of medicine but stil in a same position I lost my weight also I did my ultrasound test report showing that my liver is little bit big and lot of gas in my stomach and lower part of the abdomen . When I use medicine I am feel better and when I stop to eat medicine it starts, kindly advise me medicine .[/INST]Dear .... Many thanks for the mail. A slightly big liver usually does not mean anything serious unless the liver function tests show some abnormal readings. So an LFT needs to be done. Like wise ultrasound evidence of gas in the stomach also does not mean anything. You will require an endoscopy test if not already done and I need to know the report. If you feel better while you take medicine denotes that you have some acidity problem. I suggest you continue the same medicine till you send me the reports I asked for. Taking these medicines for a long period of time will not cause any harm. Rgards</s>

<s>[INST]How is it that a medical expert could use the 1990 ACOR criteria for Fibromyalgia in July of 2009, when was the preliminary available? I don t have any money, I am now disabled and not working, I need help and some answers. Is this questionnaire set up to help or to make money? Sorry about the attitude but I am tired of trying to find the truth about my case and because I am unable to make the living that I once made because of the Fibro, I am left in the dark.[/INST]Hi, thank-you for providing the brief history of you. A thorough clinical Musculoskeletal assessment is advised.a little knowledge about the fibromyalgia is needed. Fibromyalgia is a condition where the pain is in the fibers of the muscle. Each muscle is composed of multiple muscle fibers and inflammation happening there will lead to the dysfunction in the circuiting of the muscle fibers to produce the contraction and relaxation. Also to understand here that the medication is a symptomatic relief and not a long term solution as the body is a medicine of its own and medication used acts as a supportive therapy to allow body to heal on its own. Also, in my clinical practice most Fibromyalgia cases we recommend physical therapy, meditation and breathing exercises. As physical therapy will help improve the muscle refunctioning and also improve the metabolism and immune system to reduce the inflammation. Also, Therapeutic ultrasound therapy and TENS therapy have been useful to reduce the pain, but importantly exercises are the choice. Meditation helps improve the control over the anxiety and leads to cooling of aggression. Breathing exercises helps to improve the oxygen carrying blood cells which acts as a fuel in the metabolism and reduce the metabolic waste as well. RegardsJay In Chat Doctor. </s>

<s>[INST]My grandson has to have a liver transplant,he is having to have all his injections within the next 8 weeks because when he has the op he will not be able to have them, he is 9 months old and within the next 8 weeks he will be on the transplant list, my grandson and my son and partner were at kings college last week for three days digusing all that was going to happen, my son has put his self forward as well to be a donor for his son which is my grandson which is a scary for me to think about as i do worry about them both, is this operation safe for them both i know if ralph dosent have it he will not be here but just need to know as my son only tell me what he thinks i should knowCan you please answer these questions for me thankyou[/INST]-Hi and welcome to Chat Doctor. Thank you for your quarry. This is complex surgical procedure, very complex. But it is very safe for donor and less safe for baby. If your son is in good shape and health then he will recover very soon after transplantation. Transplantation is obviously the only possible treatment for your grandson, so I am sure that you can ignore all possible risks of surgical treatment and give your best. Hope I have answered your query. If you have any further questions I will be happy to help</s>

<s>[INST]I have notice very slight traces of blood on the toilet paper after my 4 yr old son has a BM. It is not every time and it is slight. It has been inconsistent over the last month. Stool does appear pretty hard. No trace of blood in or on the stool. I plan to speak to our pediatrician next week when we are there for a flu shot. Should I be worried?[/INST]Thanks so much for consulting in Chat Doctor. Your son has usual problem because his stool is very solid, don't worry, but pay attention to his anus, it seems he has fissure there, it looks like as scratch in red color, you can give him call suppositories 1 CBPP before night per rectum 5 days for healing, also you can do oil enema- 10-15 ml usual sunflower or olive oil after bowel movement, but he should lay in the bed 15 min for resorption. Please start to give him boiled blended beet roots with a little salt, garlic or onion and sunflower or olive oil for laxative effect. In addition, you can give him carrot and beet roots, orange fresh juice, apples, more fiber food and raw vegetables-tomato, cucumber, he should Chat Doctor. </s>

<s>[INST]Hi,Im a 30 year old woman, Ive always been healthy but I have this problem since my 20s. Whenever Im nervous, anxious, emotional, really unhappy about something or really happy about something, I start sweating, my chest and neck become very hot and red blotches appear mainly in my chest very rapidly. Is is very disturbing in social situations. What can I do to solve this problem? Thanks[/INST]Blushing is a common reaction. It may be a part of social anxiety disorder or social phobia. If blushing, sweating, along with possibly tremors or stuttering occur when you are in a social situation; you may seek the help of a psychiatrist. The other features of social phobia which you may be having are:1) Fear that people will evaluate you/ judge you negatively when you are in a social situation. Such fears are more likely in public speaking, talking to a crowd, or meeting many people at a party or social gathering.2) Many people have symptoms described in 1) above. But they should be severe enough to cause limitations in your functioning. Or you find the anxiety so severe that you avoid situations completely. This then leads to further social problems.3) You think this fear is excessive, but seem to have no control over it. There are medications as well as Cognitive Behavioral Therapies (CBT) for dealing with social anxiety. The disorder is sometimes almost a part of your personality, that it stays throughout life. However, medications or psychotherapy will help you deal effectively with the symptoms. Do seek a psychiatrists' opinion on it.</s>

<s>[INST]Hey there I ve been having these slight heart burns for two weeks after taking mdma mixed with weed & a little bit of alcohol & I was wondering If I am gonna recover from this? Parts of the day I feel normal & then the heart burn creeps up on the random. I feel lost, no sense in reality, low energy, & I start to get quiet. Most of the say I feel like im dieing slowly.[/INST]Hello! Thank you for asking on Chat Doctor! Coming to this point (facing your actual complains and overall clinical scenario), I strongly recommend you to consult immediately the nearest ER service in your living area, as those cocktails (MDMA, weed, alcohol, etc.) are very dangerous for your health, especially for your heart. They may exacerbate form mild blood pressure fluctuations, to serious arrhythmias, sudden heart attack, and even cardiac arrest and death. So, do not lose any more time, but ask medical help, to undergo a careful physical exam, resting ECG, several lab tests (like complete blood count, CK-MB, troponin, AST & ALT, renal function tests, blood electrolytes, etc.), and rule out serious health conditions, as well as start an appropriate therapy for your health status. I strongly recommend you to avoid having such dangerous substances in the future, to protect your health and life. Hope to have been helpful! Greetings! </s>

<s>[INST]I am experiencing a right side dull pain in my temple and at times sharp. My right side cheeks and face feels kinda tender when touched. I know I have been experiencing headaches and neck pains as well. Im just concerned due to a previous aneurysm on right side in back of my head lower to neck.[/INST]Hello, I can understand your concern. It is logical that you can assume it to be aneurysm again as you have had it before. However, if it was aneurysm, you should be feeling symptoms like pulsations, numbness over the area etc. What you are experiencing is a sharp and dull pain episodes in the cheek area which seems like pain from infection of the oral cavity or due to sinusitis. It could also be pain related to Trigeminal or Facial nerve. I would advise you to visit a dentist for examination of the oral cavity to look for presence of infection in the area. If dentist clears you for any loci of infection, an ENT specialist or physician can examine you for sinus or nerve related problems. By the time you see a doctor, you can take Ibuprofen 400 mg or Motorola 10 mg up to thrice day to have relief from pain. I hope this information helps. Thank you for choosing Chat Doctor. I wish you feel better soon. Best,</s>

<s>[INST]Hi, and thanks for checking up on me. I have not yet figured out why I cannot move in the daytime, but in the dark and at night I can. I considered hemochromatosis, but the symptoms don t really fit. I have started an herbal tea medicine to work on the bone marrow, and it seems to be very slowly improving. But I still can t explain why it happens in the first place. Thank you for your help. It is very appreciated. - elaine silverman[/INST]Hi Elaine, Thanks for asking. Based on your query, my opinion is as follows.1. No, hemochromatosis does not cause difficulty to walk. 2. I am not sure if it is anything related to hemochromatosis as you can walk at nights and not in day. Are you able to move your limbs during daytime? If you are able to move any of the limbs, then you will require psychological support and counseling.3. Routine hologram along with serum iron investigations will give a guide on hemochromatosis. Liver biopsy can confirm it. If more details are available regarding investigations and clinical history, I can be more helpful. Hope it helps. Any further queries, happy to help again.</s>

<s>[INST]hi my name is Ashish and I am a student.I having some problem in my head. my mind is always go out of world thinking useless.I cant stop even if i want due to over thinking my head from back start paining.This always happen when I am not doing anything or when I am studying.If this is a kind of any disoder or dieases then let me know.I forgot to tell u that sometimes thingking in nights do not give me good sleep[/INST]Hi there! Mind is not vacuum, it cannot remain empty. Being young, you have a lot of energy, please channelize it in proper manner, please do at least 30 mins of any aerobic exercise, not only for physical fitness but also for mental peace, it releases happy hormones. Please form list of goals, short term and long term too. Keep the track of every hour may be at least 6-8 productive hours a day in Excel sheet, to know what you did in that hour. Have half glass of hot milk an hour prior to sleep, this will ensure good sleep and will boost generalized wellbeing in you. From the information what you have given i don't feel It's something serious to worry., but please consult a Psychiatrist/Counselor if you don't improve with above measures.</s>

<s>[INST]hihiFrom last one and half year am trying to get conceive... but still got not any positive result ..Done every test likr HSG,Hysteroscopy,thyroid profile, also done husband test...that all tests are normal.... Last month once again done Prolactine level,thyroid profile and AMH Levels test done, In that prolactine levels and thyroid stimulating hormone are high so how to move further on this... Please advise me on this[/INST]Hi, The cause of your infertility is hormonal as is evidenced by the high levels of Prolactin. You should see an endocrinologist and get further management to attain normal hormonal status. Meanwhile, please maintain a healthy weight, healthy diet and regular exercise. Do not go for ovulation induction prior to achieving normal hormonal status as this may not be successful. You would need Chat Doctor. Hope you find this information helpful. Take care.</s>

<s>[INST]Every now and then...every other week or so....i have a knot that shows up right next to my spine and it itches....in my lower back....by the end of the day it is gone....what could it be?[/INST]HI, Dear,Thanks for the query to Chat Doctor. I understood your concerns about the shin lump. In my opinion its -Urticaria-CIU (Chronic Idiopathic Urticaria)Treatment-a-Take opinion from your ER physicianb-He would do Blood test for eosinophilic / Stool for the worms and amoeba. Hope this would resolve your worry. Hope this would help you to plan the treatment with Your family doctor. Wishing you early recovery. You are always Welcome for further query to Chat Doctor in this regard. Have a Good Day...!!</s>

<s>[INST]I am 6 1/2 months pregnant. Woke up this morning having chest pain. I didnt pay mind to it and continued with my day. Afternoon I took two Tylenol thinking the pain would go away and it hasnt. The pain is my dead center chest, in between my breast. Feeling like I cant breath. Like my chest is Caving in and someone punched me there a few times. What is it?????[/INST]Thanks for your question on Chat Doctor. I can understand your concern. By your history and description, possibility of musculoskeletal pain is more likely. But better to rule out cardiac chest pain first. So get done blood pressure monitoring and ECG. If both these are normal then no need to worry about heart diseases. Apply warm water pad on affected areas. Avoid movements causing pain. Take painkiller and muscle relaxant Chat Doctor. Don't worry, you will be alright with all these. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.</s>

<s>[INST]I have had severe right side pains that have been going off and on since yesterday, but tonight they have been pretty unbareable. I have taken Ibuprofen at 9:30 and again just now. I have no swelling and no fever, just pain...I am guessing in and around the 11th and 12th rib. Pain seems to be mainly in the back. I feel better when I stand up, however around 12:00 this morning I took a warm bath and followed up with a warm shower and pain was gone completely! I was able to sleep till now where pain is back, same place and is a dull stabbing pain. Looking at symptoms could this pain be kidney stones?[/INST]Hello, I read carefully your query and understand your concern. The symptoms can be related to kidney stone. I suggest doing an abdominal ultrasound for further evaluation. Meanwhile, I suggest using a plasmolytic such as Tuscan to relieve the pain. Warm compresses can also be helpful. Hope my answer was helpful. If you have further queries feel free to contact me again. Kind regards! Chat Doctor. </s>

<s>[INST]I have been told I have bilateral renal cysts. nothing has ever been done about them, but for the last moth or I have had pain all throw out body includeing to the tips of my fingers. this happens prior to voiding of which I have no control. could this be do to the cysts ? I also have very sharp pains off and on in the lower left back gem18@[/INST]HelloMostly simple renal cysts are asymptomatic, and it is an incidental finding. It may cause symptoms if there is increase in size or infection inside the cyst. Pain may be due to many other reasons like urinary tract infection, musculoskeletal reasons etc. Your condition need proper clinical examination and further investigations. X-ray of L/S spine and urine RE/ME, C/S should be done. Treatment depend upon findings. Get well soon. Take Care Chat Doctor. </s>