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<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Could raised heartrate be due to intake of decongestant for vertigo while being on Lexapro, risperdal and vyvanse? Patient:My resting heart rate is 102 BPM. I take Lexapro, risperdal, and vyvanse. I just added a decongestant to alleviate pressure on my ear canals causing vertigo. I realize the raised heart rate is most likely a result of these medications. Is this cause for concern? Lexapro 10mg per day Risperdal .25mg per day Vyvanse 70mg per day [/INST] Doctor:Hello, Decongestants can increase a person's heart rate.This can lead to further complications if the user has pre-existing conditions.So, I suggest to avoid using decongestants.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Dorina GurabardhiGeneral & Family Physician </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: How can wheezing along with cough and acid reflux be treated? Patient:I’m wheezing with a non productive cough from the flu. I have a history of asthma but have been symptom free for 8 plus years. I have a pro air inhaler, I’m taking mucinec expectorant and Zertec-d. I don’t have medicine for my old nebulizer or a preventative inhaler. I just looked and my allergists office is closed on thursdays. My chest burns. My stomach muscles hurt. What else can I do for the symptoms? I should have known it cost money. Never mind. I’ll go to the er when I can’t stand it anymore [/INST] Doctor:Hello and Welcome to ‘Ask A Doctor’ service.I have reviewed your query and here is my advice.For chest burn at least use soda bicarb containing fluids like cold drinks, use excess water, cold milk, or ice-creams. You need x-rays and again inhaler therapy and antibiotic for treatment.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Chandra Shekhar </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Pain in lower belly. Follicles found in ultrasound. Is it cancerous and curable? Patient:hi good morning i have pains in my left side of my lower belly went to my doctor who sent me for an ultra sound which shows i have 15 + follicles,is that cancerous and is it curable. Then he said i may not have kids not a problem i have 4 lovely daughters and i tie my tubes date 14-08-2000 where it was cut and laser burn it is call [BTL] for short here in Trinidad and Tobago please help [/INST] Doctor:Dear bybygirl there is no reason to worry. More then 95% of ovaric cysts and follicle disorders are benign. Usually hormone disbalans trigger ovary hypertrophy and menstruation abnormalities. Your pain can be caused by ruptured follicle or cyst. You should check your estrogen and progesterone levels . Also laparoscopic examination can be performed to clearly visualize your ovaries and also can be theapeutic . Ovaric cancer are the one of the worst tumors but it would be seen on US as a fast growing mass, you can check tumor markers just to be sure. Wish you good health, Dr. Ivan Romic (Rominho) </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Can orgasm lead to burning sensation in the urinary tract? Patient:I had sex with my wife last night, almost immediately there after UT burned when I peed, I had not noticed much today, but tonight when I went to shower it was burning again, I had a white milky looking fluid in my penis, and it seems to be burning continually now not stop [/INST] Doctor:Burning sensation with urine is almost synonymous with urinary tract infection. You should get you urine sample analysed for blood n pus cells n proteins n also get a culture study done. As you say d color is white , a stone could b a cause as well. U should also get a USG of k.u.b region. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: How to treat Vitiligo white spots in a child? Patient:Hi.. my daughter has just shown signs of Vitiligo... white spots on back and pinkish on and around eye. Consulted a dermatologist and he said its early or pre vitiligo. we wish to know whether we opt for Allopathic or Ayurvedic or Homeopathic treatment. Choice of treatment is highly confusing for us. Want to treat her asap before it spreads and ensure mininal side effects. Please advice on method of treatment. [/INST] Doctor:there no term like pre vitiligo please do not hurry to treat this conditon apply liquidparrafin one hour before bath expose the child to early morning sunlight ,avoid talcum powder .of cource the best treatment is allopthy </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest non surgical treatment for blocked follopian tubes Patient:hellow doc am sue from kenya have been married for four years but no kid i was told that my follopian tubes are broked is there ant thing i can do apart from going for opparation is there any medicine i can take to to unbroke my follopian tube plz tell me [/INST] Doctor:Hi welcome to healthcaremagic.I have gone through your question.Your fallopian tubes should be blocked not broken!!!!Blocked fallopian tubes couldn't be reopened by medicines.Surgery should be done to recanalization of tubes.Hope i answered or question.Would be happy to help you further.Take care. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Q. What does abutment of the nerve root mean? Patient:Hi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for annular bulging and tear? [/INST] Doctor:Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online --> </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Severe lung infection affecting kidney. Dialysis suggested. Have diabetes. Can she be cured? Patient:Hi Mom is a patient of Diabetics for last 10 yrs and has High blood pressure, 3 weeks back she was admitted to hospital with Severe Lung infection (neumonia) and was on ventilator for 5 days and in ICU for nearly 7 days now doctor says she would require dialysis as infection has effected her kidney, She did not had any problem prior to this , I have consulted another specialist nephro and he asked me for getting Kidney profile and Hemogram test which i did where i saw a Urea level of 23 and creatinine level of 4.6, My question is can this be due to the fact the she had infection and it effected kidney also and can this be cured or she wil need regular dialysis from know on. [/INST] Doctor:Hi friend Welcome to Health Care Magic Sorry to see several problems - The best one to seek in the situation is a nephrologist - you are right in consulting one. Infection can cause all these - often leading to shock and Multi Organ failure. Ther chance for reversal are not predictable until after the infection has cleared. There is one thing that needs attention - Urea of 23 and creatinine of 4.6 ?? - this is rather unusual' If it is not your typing error, it suggests skeletal muscle problem, rather than kidney! The nephrologist will assess and assist Take care Wishing speedy recovery God bless Good luck </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Had dental abcess in wisdom teeth. On Clindamycin. Having temple pressure, sinus pressure, jaw pain, swollen throat. Suggestions? Patient:Hi I have had an dental abscess in lower wisdom tooth for three months been on clindamycin 300mg 4 times a day basically once a month with another perscription I have temple pressure and pain jaw sinus pressure ear pain and swollen throat gland saw doctor in er last Thursday finally was able to get a appt on the 17th this month to meet my surgeon im a worry wart and dont want to die cause I wasn't smart and read stuff online do you think im fine [/INST] Doctor:Hi,If there is abscess in root of molar tooth, it may not respond with antibiotics.In this situation pus should be drained or extraction of molar tooth is required.Consult dentist and get examined.He will decide the plan of treatment.Ok and take care. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: May have paranoid schizophrenia. Drinking, drug abuse problem. Episodes of confidence and depression Patient:Hi there,i am starting to realize that i could possibly have Parinoid Skitz...i have been suffering 4 a few years now,also drink and drug abuse has been a problem on and off 4 about 15 years,i am 29 and find everyday tasks difficult,i can t communicate or express myself propperly sometimes and feel that others are always judging me as stupid or lazy,i have become very interested in human phycology as a result of trying to find out the cause and effect. Also i have taken a keen intrest in Buddhist philosophy and meditation practice. I go through very intense periods of straightness,no alcohol or intoxicants 4 days,weeks or months which do benifit amazingly,almost to a point of whethering mania and confidence only to come chrashing down into depression when i get bored,loose faith or get too intense and get smashed on a one night binge out with friends.and all that good work is wasted and onset of paranoid skitz.comes on. Drink and drugs trigger it off, where as when im straight,i still have deranged delusional thought patterns but i don t feed or respond to them,they are simply conditioned phenomina,coming and going,rising and falling,changing all the time.(i don t cling to them so much) Or my minds creation,if i believe the voice in my head,i can create my own heaven or hell creation and destruction. I generally believe that mental illness is just affliction with ones own ego and in Buddhist doctrine,the ego is not a real thing,it is a delusion, just ones own mental projection through ones perception of the 5 sense organs and as to how one inturprits and responds to that stimuli. [/INST] Doctor:Hi, As you are already aware of your problem then schizophrenia become least probable diagnosis in your case. In schizophrenia person do not insight for being ill. For me your problem is closely related to substance use. Simplest way to help yourself is by stopping substance. If after that some symptoms remain then for assessment and treatment, you can visit specialist like psychiatrist. I hope this information has been both informative and helpful for you. Wish you Good Health. Regards, Dr. Ashish Mittal </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest treatment to overcome fear of men Patient:I am a female age 32 due some reasons I am not able to face people especially male ....I am scared of male ... i have cultivated a strange behavouir of looking at their private parts that I dont do intentionally.... i cannot resist.... I hve gone 2 or 3 molestations in my childhood may b that is the reason.... I am not able to Live peacefully now [/INST] Doctor:DearWe understand your concernsI went through your details. I suggest you not to worry much. From the given symptoms, this is just a case of obsessive thinking or a compulsive behavior. In short OCD, but not clinically manifested. If you try to resist it, the behavior pattern will try to over whelm you. Therefore, the best treatment method is ignorance. That can be easily achieved by busying yourself for a period of around 30 days. Make yourself so engaged that you have no spare time to think about this. Ignorance sometimes is a bliss.Psychotherapy techniques should suit your requirement. If you require more of my help in this aspect, Please post a direct question to me in this URL. Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques.Hope this answers your query. Available for further clarifications.Good luck. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Could recurring, red, spotty, raised rash on cheeks of an infant be ringworm? Patient:My son is 18months and gets a recurring red spotty, raised rash on his cheeks. one doctor said possibly ringworm, but i'm not convinced. Dactacort helped after a few days but maybe it just ran it's course? It has happened 3 time snow and once woke him up clearly in pain. [/INST] Doctor:Hi... I feel it could be an eczema. The trick of the management is keeping the skin moist and never allowing it to be dry. For this oil massage and lotions like Oilatum will help. Regarding cure options - eczema is a sort of allergy...allergies can only be controlled and can never be cured. But usually kids grow out of it...that is as the age progresses, they become better starting from 6 months.But...kin 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 Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed)., </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes upper abdominal pain? Patient:I don't get sick often...and it is because of this... that sometimes I worry when something unexpected happens in my body. This morning I felt {9am} a slightly sharp vertical pain from my stomach area...(coming from about one (1) inch away - to the right - from the center area between my belly button and the bottom of my sternum...I thought I'd drink some tea, and it eventually went away. It is now about 4pm...finished eating about an hour ago, and the pain came back!I though I get an opinion...ty. Rob [/INST] Doctor:Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. It looks like you have indigestion problem or GERD. You can take omeprazole for that if available over the counter. Or try not to take meal on full stomach, and don't take liquids after meal. When you take your meal, you should not lie down immediately and have a little walk of at least 40 steps. There is nothing much to worry about. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Imran Zeb </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Has jaundice, liver cancer. Stopped chemotherapy. What now? Patient:Respected Doctor My mother is suffering from Jaundice from past 15-20 days due to liver cancer .Because of jaundice the doctors have stopped her chemotherapy .They are saying during jaundice we can t continue with the chemotherapy. So what should we do..? And can you suggest me a healthy diet for her so that we can cure jaundice fast..and her chemotherapy can be started again. Please reply soon Thanking you [/INST] Doctor:Hello! Thank you for the query. Most likely your mother has jaundice due to impeded bile flow from liver bile ducts. In such case, it is possible to restore bile flow with two procedures. First one is ERCP where with endoscope it is possible to put small tube into the bile ducts what should help with bile flow. Second is percutaneous transhepatic drainage where with a needle liver bile ducts are drained from the outside (through the skin). Unfortunately there is no specific diet for such type of jaundice. Hope this will help. Regards. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Are there any pills rather than inhalers to treat COPD? Patient:I have copd. I was on symbicort 2puffsmorning and 2 puffs evening. Along with Tudorza 1 puff morning 1 puff evening. Due to cost I ask doctor to see if I could get cheaper. I m trying spiriva once daily. With qvar 80 once a day. I started out spiriva in am it only lasts 4 hours at most. So have switched to evening. I have started cheating with at least one puff if symbicort especially if I leave the house. I tried advair and second day my voice leaves me. There is a new product breo inhaler would it be worth trying. I don t smoke anymore. I have oxygen at home. Do you think there might be a pill we could take [/INST] Doctor:Hello dear, thanks for your question on HCM. I can understand your situation and problem. COPD (chronic obstructive Pulmonary disease) is chronic, progressive obstructive disease of the airway. It is incurable. Inhaled treatment is the first line therapy for COPD. And if patient is not improving or controlled with Inhaled treatment then we can add oral bronchodilators too. Oral bronchodilators are theophylline group. Acebrophyllin and doxophyllin are commercially available. Since both are prescribed drugs, you need doctor's prescription for them. You should also enroll yourself in pulmonary rehabilitation center where chest physiotherapy and deep breathing exercises are done. These will improve your lung function and decrease the symptoms. So consult pulmonologist and discuss all these. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes solid lump on the inside of buttock near anus? Patient:My partner has developed a solid lump about 2cm on the INSIDE of his left buttock close to his anal passage. He's in absolute agony with it. What could it be? This is the fourth day he's had it now and it's just gotten more painful. He does a lot of driving, could this be the reason why? [/INST] Doctor:Hi,From history it seems that there might be having developing abscess over that region.This can be due to ingrown hair follicle infection and part remained more wet due to perspiration and less airy.Her might require one course of antibiotic and anti-inflammatory medicine course for 5 days.Once abscess is formed, it might require incision and drainage of pus.With antibiotic medicine there are all chances of clearing the infection.Ok and take care. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What could cause demyelinating of brain? Patient:i had a mri and have several automune disorders,hypothyroisim,have had b12 defeciency have thalasemia minor,pernicoisanemia. my brain shows demylienating severe does that mean i inherited adult luekodystrophy from my dad. or is my brain changing because of disorders im not weak and falling my dad was when he was my age. thank you. they said it might ne adrenelennueropathy. [/INST] Doctor:Hello, I would explain that demyelination and leukodystrophy are two different disorders. They have different characteristics on MRI. I would like to review your MRI report for a more professional opinion if you could upload them for a second opinion. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes abdominal cramps and vaginal bleeding during pregnancy? Patient:Hi! i was 5 weeks and 5 days pregnant and i started spotting in my sixth week of pregnancy. It started off with bright red bleeding that lasted only for a very short time and then turned brown and very light. it stopped the very next day. A day after that i started bleeding heavily, bright red and also passed big blood clots followed by severe cramping, dizziness and nausea. i went hospital that day and had both transvaginal and pelvic ultasound and the doctor said they could not see the baby in there but the blood test for HCG hormone came positive indicating i am still pregnant. Its been two days now and i am still bleeding, cramping and feeling dizzy. What does this mean? [/INST] Doctor:By 6 weeks of pregnancy, we should definitely be able to see a baby and a heartbeat on ultrasound. What you are describing is concerning for a spontaneous abortion (miscarriage). The fact that they couldn't see a baby is also concerning. We have a rule in the OB world- a positive pregnancy test without visualization of a baby is an ectopic pregnancy until proven otherwise. An ectopic pregnancy is a pregnancy outside of the uterus, usually in the Fallopian tube- this can be life-threatening and needs to be treated either medically or surgically. I am not fazed by the fact that your blood hormone hCG was positive- it can take a couple weeks for the hormone to disappear from your system after a miscarriage or during an ectopic. Your hormone level needs to be monitored every 48 hours until your doctor can clarify if this is a miscarriage, an ectopic pregnancy, or a normal pregnancy. With the amount of bleeding you are having, it sounds like you are miscarrying. However, I cannot rule out an ectopic pregnancy at this point. Please follow up with your doctor as soon as possible, especially if you are still bleeding heavily or having a lot of pain. Heavy bleeding can make you anemic, which may mean you could need a blood transfusion. Severe abdominal pain is concerning for an ectopic. Either way, please follow up with your doctor. Best of luck! </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Reason for swollen left hand and raised spots? Patient:My 15 year old son has a swollen left hand, in addition he has raised spots on his hands and forearms and on his legs. The spots ich and look like a cross between hives and swimmers itch. Symtoms started late last night with just the spots itching, Then progressed to his swollen hand. What do you think it is? [/INST] Doctor:HiIt could be some allergy or insect bite.Show to a doctor.Meanwhile give give him Allegra 90 mg once a day, and Prednisone 4mg BD for 3 days.He may apply beclametasone ointments on itchy areas alsoA CBC blood count should be done.if has pain, give Tylenol.Avoid any other medication if was on before, consult physician.Look to any diet he's been allergic or intolerant to </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes fever and rashes on body? Patient:Hi a friend of mine has been having fever on and off for the last 4 days, he has rashes in most parts of his body (then on occasion it disappears but right now when he started having fever it stayed red and itchy), he's having head, body and joint aches and a heavy feeling in his eyes. Lab result was low wbc and a trace of blood in his urine. What could this be? [/INST] Doctor:Hi. Fever with rash and joint pain is seen in many conditions. Most commonly seen in viral fever like dengue or other viral fever. You have low wbc count which also favour that. Go to the doctor and take treatment. And regularly measure platelet count. You may have low platelet. If it is severely depleted then it may leads to life threatening bleeding. So keep close watch on that. And take plenty of fluid orally. It will go away in few days. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest medication for yeast fungal overgrowth Patient:I m trying to find a doctor that can help treat my family for yeast fungal overgrowth. we have been going back in forth to doctors for since 2008 which we bought a home in 2007. Every since we moved in that house we started being sick , and we lived there almost 6 years, and i came to the conclusion it was the house making us ill.. I ve done alot of research but no doctor will help me, and t states you can move out of the mold environment and still have the problems and that we gotta get it out of our system or it will keep you sick !!!! Please help find a doctor that can help us .. i live in greenville ms thks [/INST] Doctor:Hello, Thnx to contact us. I understand your concern. If I am your doctor I advice you that you should be tested for fungal allergen testing. If it is positive you should start with anti fungal medication. Once the treatment is started it gradually disappears.I will be happy to answer more of your concerns, kindly know me,Wish you a very good health at health care magic. Dr. Arun Tank. Infectious Disease. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Is it difficult to get positive pregnancy test with IUD? Patient:I went to get my IUD out and they couldn't get it because it's tissue has been going around the strings. I'm freaking out. They also did a pregnancy test which came out negative but I've heard that with an IUD it's hard to see if your pregnant with Just an urine test? [/INST] Doctor:Hello,I have gone through the query and understood the concern. Pregnancy test can be performed as usual with an IUD in situ. If it happens to be a hormone IUD, it may be difficult to read the test, but, there should be no interference with the result. In fact, in such a scenario, the blood test and sonogram help a lot. If your IUD could not be removed under naked vision, I would suggest ultrasound-guided removal, which is often successful. If still difficult, you will need a hysteroscopy. Hope you find this information useful. Take care. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes soreness in upper left arm? Patient:Hi there, i have had a really sore upper left arm i am a housekeeper at a buzy backbackers in town and my job is very physical making 171 bed lol um my arm is so sore ican hardly move it iwent to work this morning and it wasnt painful at all i was able to work fi e but now i have come home and ican hardly move it the pain is so bad ..... i am a 39 year old woman that is well with no medical issues... im thinking i may have strained my upper arm how???? Can you please suggest what may be going on thanks :-) [/INST] Doctor:Hi,I am Dr Ramez Mohamed, I had gone through your question and understand your concerns. I think you suffer from inflammation of the left shoulder joint or inflammations of the origin of the muscles and ligaments forming the joint and so as a result of the continuing use of the joint, resulting in compression of the bone-forming the joint on the ligaments and ms. With rising up of the arm may be extremely painful. You must get an X-ray and MRI scan to detect the defect and further investigation : ESR , CRP You have to take some of the pain relievers and anti-inflammatory with no moving the arm for at least two weeks with arm sling and you will feel completely comfortable.Hope the above information helps you and if you have additional or follow up questions then please don't hesitate in writing to us. I'll be happy to answer your questions. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Can non-penetrative intercourse cause pregnancy? Patient:me and my girlfriend were fooling yesterday,we kissed and for the first time my penis touched her vagina but there was no penetration,when i felt like coming i moved my penis quickly to a laps and thats were i released my semen,now she has started her period today,is there a risky of her being pregnant and does the menstrual fluid wash away the semen in case there was a bit of spillage?please help [/INST] Doctor:if she has got her period then there are no chances of getting pregnant from your last event of sex. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What are the symptoms of potential pregnancy? Patient:i have had many signs and symptoms of pregnancy like a lte period getting sick the veins on my sides are very noticable and on my arms and chest and legs but i took a test it came back negative and then i was a week late but after that i got my period. is there any way i could still be pregnant? i also have leg cramps and pains in my arms too [/INST] Doctor:Hallow Dear,The first cardinal symptom of pregnancy to appear is missing a period. All other symptoms like nausea & vomiting, frequent urination and the breast symptoms like engorgement with tenderness, dark discolouration of nipples & areola with widening of areola and secretions through nipples appear subsequently, usually 10 to 15 days after missed period. Though you had some vague symptoms, ultimately you have got your menses. Probably after having the menses, the symptoms also might have vanished. When in doubt, urine examination for pregnancy gives clue. That also is negative in your case.So Madam, no missed period and pregnancy test negatives confirms that you are not pregnant. Dr. Nishikant Shrotri </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Experiencing pain in throat. Cancer survivor. What should she do? Patient:my sister has been experiencing pain in the throat since May after a shingles shot. Symptoms occured exactly2 weeks after and she has been going to an oncologist, ent, gastronologist and none have been able to find what iscausing the pain. She also had an outbreak of sores in her throat after the vaccine in which md thought it was avirus but no one has biopsied to see why she is having this horrible pain. She is now beside herself since ct scans,mris, endospies(2) have been performed and still severe pain. She is a cancer survivor and is horrified of cancer of the throat. What should she do? Could she have had a slight outbreak of shingles and is having the pain that comes after shingles. Very worried and do not know where to turn now. [/INST] Doctor:pain as a presentation of cancer is very rare and presence of pain usually indicates inflammation or infection. as she had shingles, must have developed post herpetic neuralgia which causes a severe radiating pain on slight touch of affected area. it requires physician or neurologist consultation for the use of anticonvulsants. in severer cases ablation of the affected ganglion may be useful.you have not mentioned the type of cancer she had earlier? </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What does "bilateral renal parenchymal disease grade1 mean" in renal ultrasound? Patient:My 17 year old son had frequently raised blood pressure.He recently has renal ultra sound which reveals bilateral renal parenchymal disease grade 1?.Cortical ecogenicity of both kidneys is slightly increased and corticomedullary differentation is preserved.What all this mean and how it can be treated . [/INST] Doctor:HelloThanks for choosing HCM. As he is having hypertension there will be effect in his kidneys in which the high Bp will damage the function of the kidneys. Please have regular serum creatinine test done and if there is any increase in that you consult a nephrologist to start the treatment. The most important treatment for him is to maintain his bp. ThanksDr.Alekhya </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Can I get Implanon implant if I have high blood pressure? Patient:I'm 19 and I have high blood pressure sometimes and others it is perfectly normal. I am on progestin only birth control pill and I want to get the Implanon implant. Will my doctor perscribe it to me if my blood pressure is high when he takes it? I am also overweight. [/INST] Doctor:Hi,It is not normal to have high blood pressure at this age. What is your BMI? One reason for your high blood pressure could be you being overweight. You must reduce weight. This is important for your overall well being too.I advise you to first consult physician to find out the cause for high blood pressure and get it treated.You can have the Implanon inserted while being treated for high blood pressure. There is no problem with it.I hope I have answered to your satisfaction. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest treatment to lower WBC count Patient:Hi, my 2 y/o son has 14-16 wbc in urinalysis, after 7 days of antibiotics the count lowered to only 12-14. This is the 2nd time he was diagnosed with uti. During the first time, the wbc count lowered to normal but now it has barely gone down. What should be the next step? Thanks. [/INST] Doctor:Hi,Thanks for asking.Based on your query, my opinion is as follows:.1. It appears to be resistant urinary tract infection.2. Need to get culture and sensitivity of the urine sample to identify appropriate antibiotics.3. Also need to give him plenty of water. After completion of course of antibiotics, repeat urine test for confirmation.4. Pus cells should reduce. Not to worry.Hope it helps.Any further queries, happy to help again. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes dizziness with itching buttocks and chest pain? Patient:I sometimes feel dizzy when standing and talking with a person. My buttocks is itchy and only when I press on my upper chest I feel a small area (size of nickel) of pain. I had my upper chest checked out a while ago and the doctors could not find anything with an x-ray, bone scan. I am 37, 5,4", and 123 pounds [/INST] Doctor:Hi, Dizziness, pain in chest and itchiness all the symptoms are not related to each other. Blood pressure either high or low may be responsible for the dizziness. Get a regular checkup of BP by your GP. Pain in the chest may be a vague symptom. Take anxiolytic to get relief. Itching on buttocks may be due to fungal infection or dry skin. Consult the dermatologist and get a perfect remedy to get cure of the skin condition. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilyas Patel, Dermatologist </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Pain near ear, face feels warm, ears feel wet, numb hands. Pinched nerve? Patient:Last night I woke from my sleep with a Sharp Pinch and a burst sound on the left side of my head just above my ear. I could not sleep in fear of a bug bite . Today, my face feels warm and my ear feels wet, yet my left hand has a numbing sensation. Everything looks normal. It felt like I was stabbed with a needle could this just be a pinched nerve? At what point should I be concerned. I have Thyroid issues, along with scoliosis and spinal Bifida (very very mild) [/INST] Doctor:Dear probably it is a periferic problem of the seventh cranial nerve, facial nerve.You have to take vitamins and self physiotherapy use gym to activate the muscle and if the problems persist consult your neurologist.Wishing you the best </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest medication for cold, cough & dark stools Patient:Hello, this is actually regarding my 7 month old son, who has been a little unwell the last 3 days with a cough and a cold, he has also vomitted twice and has had a temperature between 37.5 and 39, although it has dropped now however the last three poos he had had a awful smelling, dark green almost black and have slimey stringy bit in. [/INST] Doctor:Hello, Cough and cold are viral 95% of the time in children. For cold, you can use anti-allergics like Levocetirizine and for nose block, saline nasal decongestants will do. For cold, you can use Levocetrizine at 1.25mg/dose as a single daily dose for 3 days. But usually it is indicated in above 6 months age. But unfortunately, this is non-OTC. OR The other alternative is Syrup Benadryl (12.5mg/5ml) strength. You can give 2.5ml three times a day for a period of 3 days. Although this is a first-generation antihistamine medication, this is an excellent cough suppressant, please. This is OTC. For nasal block, plain saline nasal drops will do, every 4-6th hourly to relive nasal congestion. If he struggling whilst lying in prone or supine posture - you may let him sleep in semi-recumbent position like in a car seat please. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Sumanth Amperayani, Pediatrician, Pulmonology </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Q. I am taking medications for ED with no benefit. Should I go for penile injection therapy? Patient:Hello doctor,I am a 35 year old male. I have been suffering from erectile dysfunction and have tried PDE-5 inhibitors. They work, but they do not give results anymore. I quit smoking, a few years ago, when I was diagnosed with ED. My morning erection is also not as strong as it used to be. Many check-ups in the past have revealed that my lipid profile and fasting blood glucose are normal. I tested low-normal on testosterone on many occasions, around 285 ng/dl to 330 ng/dl. I have recently started using Enanthate 50 mg every third day with 0.25 mg of AI on the day of injections, as taking 250 mg bi-weekly was giving too many highs and lows. The decision to self-administer testosterone replacement therapy was made because medications have not been helpful. I am about to get married and would be on short vacation. I do not want to start the consultation at that time and waste whatever little time I will have. I would like to try penile injection therapy. Can I be prescribed that if I visit a specialist in person? Would it be an expensive treatment? [/INST] Doctor:Hello. For further queries consult a psychiatrist online --> </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: How can swollen fingers be healed? Patient:hi? i hand washed my clothes on Sunday and afterward my index finger was swollen like i it was squeezed by a door. later on Tuesday the area around the joint on my index finger turned black and itchy.. it still swollen and painful when i try to bend it. what could be the problem [/INST] Doctor:Hello, As this is a skin reaction to the soap is one. Second, there will some skin tissue wear and tear due to friction and since it was squeezed by the door so there will be a muscle injury. Just apply coconut oil and do gentle massage and use hot water fermentation for the finger muscles to relax. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest remedy for pain in the right knee Patient:I am 57 yrs old and I was climbing down off ladder and lost my balance and missed the last step on the ladder and landed on the hard floor with all my weight on my right knee I heard a loud pop but i still walked on it for about 2 hours then it hurt to bad to keep walking. I was a doctor at a clinic and she put me on light rest walking 2 hours a day. My knee is still hurting and it has been 4 weeks now. What do I do? [/INST] Doctor:hi,thank-you for providing the brief history of you.A thorough musculoskeletal assessment is advised.As I gone through the history I feel you should consult a orthopedic and get the knee assessed. As the pain is still not reduced. Also, by understanding your mechanism of injury I feel you must have injured your ligament. As you are 57, the degenerative changes in the knee must have been present and can damage any soft tissue with smallest or hardest impact.Also, your ortho may recommend you an MRI of knee to see the soft tissues within the joint.Post which the treatment will be planned. With proper medication and a combination of physical therapy you will have better strength and your mobility will also improve.in my clinical practice such cases of ligament injuries are always delayed to undergo physical therapy and the recovery time is delayed. So I advice you to take up at the earliest and make a rehabilitation process start soon.RegardsJay Indravadan Patel </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What is the medication for passing frothy stools frequently? Patient:sir, my son is 5months now. he had viral fever last week and recovered. now for the past5 days he is passing yellowish green frothy stools 6-7 times a day( usually few minutes after feeding ). he is active and have no problem. what could be the reason and tell me the management? [/INST] Doctor:Hi...Thank you for consulting in Health Care magic.It seems your kid is having viral diarrhoea. Once it starts it will take 5-7 days to completely get better. Unless the kid's having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry. There is no need to use antibiotics unless there is blood in the motion. Antibiotics might worsen if unnecessarily used causing antibiotic associated diarrhoea.I suggest you use zinc supplements (Z&D drops 1ml once daily for 14 days) & ORS (Each small packet mixed in 200ml of potable water and keep giving sip by sip) as hydration is very important and crucial part of treatment. If there is vomiting you can use Syrup Ondansetron (as prescribed by your paediatrician).Regarding diet - You can use cerelac...any flavour will do. Avoid fruit juices as they might aggravate diarrhea. You can give zinc supplements & ORS apart from normal vegetarian porridges & soups.Hope my answer was helpful for you. I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed)., </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Will taking mega 3 capsule help in reducing the cholesterol level and any side effects? Patient:My Recent Lab Reports are as follows: CHOLESTEROL, TOTAL= 239mg/dL LDL CHOL, CALCULATED= 145mg/dL HDL CHOLESTEROL=34mg/dL CHOLESTEROL/HDL RATIO= 7.0 TRIGLYCERIDES=301mg/dL GLUCOSE, FASTING (PLASMA)=103 mg/dL Somebody suggested me to take Dr. Reddy's Mega-3 capsules per day to reduce triglycerides. Will it help me to reduce above counts? Is there any side effects. For how long I can take the Capsules. [/INST] Doctor:Hi I can understand your concern....Your cholesterol level high....Particularly triglyceride very high.The drug you are telling is docosahexonoic acid which is omega 3 Fatty acid rich.It is used as nutritional supplement .But for lower down cholesterol you can better use atorvastatin like good drug that will be beneficial...You have to change life style habit for lower cholesterol.Take less fried and fatty food....Fruits more.Green leafy veg more.Regular one hour active flooring exercise done.Jogging , running will be good.Avoid smoking.Although you have not asked I would suggest you to do following investigation .......-tread mill -blood pressure measurement -usg abdomen for fatty liver and gall stoneTake care </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What is the treatment for numbness in the upper part of the body? Patient:This has happened to me 2 times in the last month. This time it lasted for about a minute and a half - the first time about 45 seconds. The upper part of my body - my arms felt like they were both going numb at the same time and sort of ticklish. it felt the exactly the same on both sides of my body - while it was disappearing I felt it sort of flow out of my body - kind of had a tight chest feeling towards the end while it was going away. now I am fine - but it was scary. I am a 62 year old female. [/INST] Doctor:Hello, As per your history, it may be due to nerve compression at the cervical spine level. For further assessment, you may require MRI neck and nerve conduction studies after consultation. For pain, you can take tablet acetaminophen. Apply diclofenac gel or ointment locally. Heating pads will also help. You may require tablet Pregabalin and multivitamin after consultation. Do regular physical therapy. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shyam B. Kale, General & Family Physician </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What is the cure for Chiari malformation and why am I suffering from headache? Patient:I have just been diagnosed with Chiari malformation. However I am reading that this is something that happens at birth. I am a 55 year old woman. Why would symptoms appear now? I am having headaches regularly thus the MRI on my head. What course of action is there? I have not met with a neurosurgeon yet. [/INST] Doctor:Hi,Thank you for posting your query.I have noted your MRI brain findings as well as the symptoms.You are spot on in doubting that why would Chiari malformation cause symptoms at the age of 55, even though it occurs at birth.I agree with you that Chiari malformation is an incidental finding in your case, and your headaches are unrelated to that. Therefore, Chiari malformation can be left alone and no surgery is needed.At the same time, we need to find out the cause of headache in your case, and treat that.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,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad, IndiaClick on this link to ask me a DIRECT QUERY: BLOG: </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Do the holes in heart of baby fill on their own with passage of time? Patient:My baby girl was born on 13th December 12. Her weights was 3.19 kgs. she was diagnosed with heart murmur by doctor. and doctor suggest me for ECO test. after ECO test he told me that my baby has 2 defects in heart. one is 7.5 mm (L R) secundeum interatrial septum defect and second is 5.2 mm (L R) Membrance interventricular septum defect. he told me it is minimum size of defect. so we needs to wait for 3 month and after that we will check it again. it could be fill automatically. so please tell is it possible to fill this hole without a operation [/INST] Doctor:Hi, ASD >5 mm is significant and is unlikely to close spontaneously. The natural course of a VSD depends to a large degree on the size of the defect. A significant number (30–50%) of small defects close spontaneously, most frequently during the 1st 2 yr of life. Small muscular VSDs are more likely to close (up to 80%) than membranous VSDs are (up to 35%). The vast majority of defects that close do so before the age of 4 yr, although spontaneous closure has been reported in adults. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Tushar Kanti Biswas, Internal Medicine Specialist </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: is pancreaticsides are cureable Patient:is pancreaticsides are cureable .... what precautions is require to over come this diseases, my child already have and now she knows it is not creable she has lost her smile daily she is in tensions [/INST] Doctor:is  pancreaticsides are cureable ....  what  precautions is require to over come this diseases,  my child  already have  and now she knows it is not creable she has lost her smile &  daily she is in tensions </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Is liver cirrhosis curable by medicine or is liver transplantation required ? Patient:can lever cerrosis is curable by medicine.If apatient suffering from lever cerrosis can not afford cost of lever transplant than for how long he can survive with medicine. age of patient s age is 60 yrs and his health is in general good. Also he does not take alcohol & he does not have any bad habit.Pl. advice [/INST] Doctor:hello, i am sorry to inform you but cirrhosis is a irreversible condition. the functioning of the liver can not be changed by the medicines. however with medicines we can prevent complications arising from cirrhosis and improve the generl health of the patient. you need to monitor the weight, look out for symptoms like swelling of abdomen and legs, vomiting of blood etc. if symptoms worsen i would advise you to consult your physician. i the mean time continue the prescribed medicines. i hope i have answered your quey. take care </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Is lack of concentration a sign of ADHD? Patient:I think I have ADHD but I'm not sure. I'm 13 years old and I'm making pretty good grades in school (B+'s, A-'s) but whenever I'm doing my homework I always get distracted and walk around, email my friends, play with my dogs, etc. etc. And my mom always tells me when I bring up the subject that I'm just overreacting and I'm just stressed but I don't know if it's just that. The only thing that makes me doubt that I have ADHD or something like that is I've never really been like this before- I've always been talkative in classes but I've never had real difficulty getting my homework done. [/INST] Doctor:Hi. Usually children have ADHD when they are really small. like when they are between the ages of 4 to 7-8. Ask your family if you had ADHD or any such attention disorder when you were little. if you did, ask them to take you to a therapist or a psychiatrist. If, however, you do not have a history related with ADHD, but you still feel uneasy with yourself while working, try segregating your time frame. work on your paper for twenty minutes and then take a five minute break and do what you wish. then come back and repeat this 20 - 5 minute frame again. hope this helps you. if it doesn't, visit your family doctor and await suggestions. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest treatment for cough and blood in phlegm after a head injury Patient:I fell down my stairs two weeks ago and had a tramatic brain injury and cannot walk with out a walker. I just got sent home from rehab because of insurance. I have terrible headache that pain pill do not help and now when I cough I am seeing some blood in my phlegm. [/INST] Doctor:Thanks for your question on Health Care Magic. I can understand your concern. No direct connection between head injury and hemoptysis (blood in sputum). But unknowingly, you might have injured chest (blunt chest trauma) while falling from stairs. And this might have injured lungs and cause bleeding. So better to get done chest x ray to rule out lung injury as a cause for your hemoptysis. Your headache is mostly due to head injury. So consult doctor and get done chest x ray. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes severe cramps in the arms post spinal surgery? Patient:Hi, I just had spinal surgery due to C3 and C4 slipped into my spinal cord. That was 3 months ago. I lost a lot of muscle mass. As I have been slowly increasing my walking I have started to get severe cramps in arms and legs. I am also constantly exhausted. What kind of Doctor should I see to investigate these issues. [/INST] Doctor:Hi, Severe cramps in muscle can be due to calcium or vitamin deficiencies. You should consult a Neurologist or physician. Calcium and vitamin supplements can be taken for relief. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Neeraj Kumar </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes sharp head pain causing dizziness and fainting? Patient:getting shocking pains through my head that make me dizzy and blackout its like two at a time quick joults that are very painful they come about every couple minutes its not a headact or migraine been going on for awhile now and every day gets worse [/INST] Doctor:Hello,Your symptoms could be related to ice peak headache, which a benign type of headache. Trigeminal neuralgia or other types of neuralgia cannot be excluded too.I would like to know the exact location of the pain? Is it triggered by eyes opening, eating or laughing?I recommend consulting with a neurologist for a physical exam. A brain MRI and some blood lab tests (complete blood count, PCR, sedimentation rate) are needed too.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Aida Quka </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: How do I overcome my stress? Patient:Hi,I have recently been diagnosed with chronic narcolepsy. I am extremely worried due to the fact that I have recently taken out a mortgage on a new property and as a result of my condition I have been forced to cut my working hours substantially. My main worry is that I can no longer afford the repayments and I have been told that stress makes my condition worse. When I took the mortgage 12 months ago I did take a life and critcal illness policy and I have spoken to them in great detail. Apparently I am not covered by this policy as my condition is not considered to be life threatening. I am at my wits end. Any advice or feedback on this would be much appreciated.Many Thanks [/INST] Doctor:HIThanks for using healthcare magicI think, you are in stress and due to that reason, you are facing problem. In case, you are feeling tiredness, sleepiness or low mood, you can try some antidepressant like paroxetine or some stimulant like modafinil that would keep you active and help you to come out of current problem. You can also try some relaxation exercise. In case, you need further help, you can ask.Thanks </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes liquid mass on armpit? Patient:Swollen armpit (Shoulder injury) feels, acts, like water pooling in my armpit, and crotch area. After a cortisone shot the swelling diminished a lot but I can mother liquid mass by leaning forward and back. Dr s have never heard of it but I have been dealing with this for 5 years [/INST] Doctor:Hello I have studied your case All your symptoms suggest systemic infection leading to pain in arm pit.Enlarged lymph node around neck and shoulder needs to be evaluated.Most common reason for enlarged lymph node is usually infection, so we can start antibiotic regime and look for results.You may need to investigate in form of complete blood count, ESR, CRP, tuberculin test, and Fine needle aspiration cytology.There could be possibility of infection like Tuberculosis or sarcoidosis.So I will advise you to consult a specialist and do required investigation.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes cough and bruise on chest along with dizziness? Patient:Hi, I developed a bruise on my chest this morning (centered basically where a necklace would hang), and I've been coughing a fair bit today. I figured the cough was from allergies, but now I'm starting to feel a bit dizzy. Are these symptoms related? Should I go and see a doctor, or am I being a hypochrondriac? [/INST] Doctor:Hello dear, Thank you for your question. Bruises usually come from local trauma whereas hives (urticaria) are the main manifestation of allergy. And usually allergic skin manifestations are numerous in different parts of the body. So your bruise doesn't seem connected with the other symptoms.Cough can come from different causes including: allergic, infective etc. You need to check it with your doctor, in case it persists.The dizziness you have been experiencing, needs attention especially in presence of other symptoms or when you have had it for more than a couple of days. In your case dizziness and cough might come from a simple viral infection that can pass in a few days.I hope this helped.Best wishes,Dr. Alma </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What cuses throbbong pain in the penis? Patient:35yr 58 kg gay male. had a nite out, osom time but i think i overdid it with de sex. been getting fisted and i feel a rather unusual throbbing pain area which seems to be suceptible to pressure and position.. has lasted 4 2 days and b4 i go c somebody id like to ask ur advise [/INST] Doctor:Hi, It may be due to some trauma due to increased sex. If there are pain and swelling you may need medicines. Get a direct checkup. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. B. Radhakrishnan. Nair, OBGYN </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Q. I have oily face. What can I do to manage it? Patient:Hi doctor, I am 32 years old. I have oily skin on my face. I need a treatment for oily skin. I want medicine or cream to reduce the problem. [/INST] Doctor:Hi. You have not mentioned the duration of the problem. I am giving a simple step, but it is beneficial. Take 10 grams of besan atta and add 3 grams of turmeric powder. Mix it properly and prepare it as a paste with warm water. Now apply it on the face and keep it for one hour. Do this in the morning and evening. After cleaning the face, apply Boroline cream (Boric acid with Zinc oxide). Consume Triphala churna 5 grams at bedtime with warm water daily. Continue these steps for three weeks and revert me. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest treatment for writing tremor Patient:I am suffering with writing tremor from last six or seven years. i have also visited so many doctors from then, but still the problem is same as before. i have eat so many medicine but without any result. pls suggest as soon as possible as this problem is very much serious for me. i am unable to write anything. pls take it seriously and suggest me the right cure. [/INST] Doctor:Hello, I would explain that some treatment options would be: - propranolol - clonazepam - primidone, etc. Botulin toxin injections and deep brain stimulation can be helpful too. You should discuss with your doctor on the above treatment options. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: How to save the person who has taken rat poison that has spread all over the body? Patient:hi sir.. my friend has taken rat poison..and now doctors are saying its too late now..her vomiting is not in control..her age is 19..weight around 48kg..Doctors are saying poison has spread in all her body..2 days before she had taken.. plz..suggest me a way to help her..plz sir [/INST] Doctor:Usually rat poisons are fatal n dangerous.Most probably the way u are telling it could be aluminum or zinc phosphide poisoning.Best management can be done only in golden hour of presentation.Management can be suggested according to the complications developed.Rat poisoning best management is usually done much before the development of complications to prevent it.In complicated cases magnesium sulphate for life thretening arrhythmias, digitalization for cardiac failure, vitamin c and methylene blue if associated methemoglobinemias.Intra aortic balloon pump or exchange transfusion are of last options. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes recurring fever in a child? Patient:My son is two and four months old. From last one month he is getting recurring fever after every fortnight which stays for two days to three.Had got his urine test done. Routine shows 2-4 h.p.f pus cells and a few epithelial cells.waiting for the culture report. [/INST] Doctor:Hi Dear,Welcome to HCM.Understanding your concern. As per your query your son is having symptoms of recurring fever which is due to impaired and reduced immunity of body. Presence of pus cells in urine is clear indication of infection to child. Need not to worry about it. Avoid cold carbonated beverages. You should get stool culture done as well. Take diet rich in fruits and multivitamins. Visit pediatrician once and get it examined to find out the cause of fever after thorough investigation. If required request your physician for any lab tests which may be required and start treatment as per that. You can take Crocin as well every 4-6 hrly. If symptoms still persists go for blood tests and then start treatment as per that. Take antipyretic drug such as paracetamol and along with that do tepid sponging in between depending on intensity of fever. Hope your concern has been resolved.Get Well Soon.Best wishes,Dr. Harry Maheshwari </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest treatment for severe stomach pain in a child Patient:my 4 yr old daughter has been crying off and on for 1 month about her stomach she has regular bowel movements and can only eat a little bit at a time till she starts crying that her belly hurts and after aboui20 min she is up playing again .. she complains 1st thing in am and several times through the day and before bed call dr. he said keep her diet bland no milk products did that for 4 days and she still complained any ideas [/INST] Doctor:Tthanks for follow up . The most common cause of pain is infection. Pain is signal of inflammation.You should react.Try to give to her antibacterial medicine - niftas 1 tab 3 times 3 days if good effect-then continue, if it will not help gi've antibiotic - cefixime. For absorbtion of toxins you can give charcoal 1 tab for night.For relief of pain- syp cyclopam(dicyclomin), follow light diet, give blended food and soup every 4hours.Recovery soonDr.Svetlana </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Circular rashes below arm pit. Sharp pain in shoulder blade. Reason for above symptoms? Patient:I have three circular rashes about three inches apart that form a triangle shape under my arm below my armpit just behind the side of my breast and also the same thing on the other side of my body under the other arm. I also have sharpe pain that comes and goes by my right shoulder blade. The pain has been there about two months. What could these symptoms be? Thanks [/INST] Doctor:Welcome to HCMGreetings of the dayNamasthe If the rash is associated with itching then its most likely fungal infection, use Candid TV lotion for it twice a week and it will definitely help.Take Careregards </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: How can I manage urine protein discharge ? Patient:urine protein discharges 1028.4 please advice further managment [/INST] Doctor:Hi shailank; welcome to HealthcareMagic Please write in detail the urine report as well as the symptoms you have so that we will be able to guide you .Just on basis of what you have written it is difficult to give proper advice. Thanks </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Can infection from water cause dizziness? Patient:my son went to my gp the other day and they told me he had a bad water infection and he had protine and blood in his we they also thort it might be his kidneys and they told me if he gets worse take him straight back he is not having the same symtoms but he is going dizzy quite alot do i need to take him back again [/INST] Doctor:Hi, dearI have gone through your question. I can understand your concern.Your son has urinary tract infection. He has protein and blood in urine so he may have some infection in kidney. It can leads to dizziness. You should consult your doctor again. He need to test creatinine level, protein level and electrolytes level. Then he should take treatment accordingly.Hope I have answered your question. If you have nay doubts then feel free to ask me. I will be happy to answer. Thanks for using health care magic. Wish you a very good health. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What are the symptoms of potential pregnancy? Patient:since last monday i have ahad sore breast/nipples among other symptoms: headache dizziness blurred vision sore breasts /increase/ tender increase in nipple size/ not as pink once felt nauseas widder waist tired moody frequent urination hard time sleeping/stomach discomfort discharge back aches I took a pregnancy test this sunday and it was negative, i should get my period around june 3rd? could i be pregnant or could this be related to lyme disease? [/INST] Doctor:HiDr. Purushottam welcomes you to HCM virtual clinic!Thanks for consulting at my virtual clinic. I have carefully gone through your query, and I think I have understood your concern. I will try to address your medical concerns and would suggest you the best of the available treatment options.1] Please do not panic.2]If you have regular periods and you have missed your periods; and still your urine test is negative, then you are mostly not pregnant.3] In this case it is just prolonged period. You can wait for the onset of periods or induce periods with Tab REGESTRONE 5mg 2 times a day for 5 days.4] Also all your symptoms can be related to Premenstrual Syndrome- PMS.I will suggest indulging in a healthy diet and regular exercise regime.Include plenty of fruits, salads, vegetables in the diet. Have adequate water intake , say 8 – 10 glasses per day. Avoid deep fried foods, bakery products, and refined sugars.Avoid substance abuse, if any.Vitamin E, B LONG F, PRIMOSA one each at night for 3 months will be of help.I hope my answer helps you.Thanks.Wish you great health.Dr Purushottam S Neurgaonkar </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What is the mediastynum cyst on the right side of my chest? Patient:Hi Doctor. I just got back from my CT scan. 3 months ago they located a 2 cm mediastynum cyst on the right side of my chest. My doctor sent me to get another CT 3 months later to see if it grew. Thy told me that it looks the same and that it is on the right side of my body near my heart. What should I do? And what is it? [/INST] Doctor:Respected user, hi I evaluated your query thoroughly .* Mediastinal cyst has vivid pathologies ranging from benign neuronal tumors to malignant ones .* Mediastinal cyst evaluation needs correlation with detailed history of the patient , clinical assessment , signs elicited by the consultant, exact location in the mediastinum with in depth analysis of reports , Biopsy of the lesion giving histopathological evidence of the disease.Hope this helps you.Welcome for any further queries.Thanks for using Healthcaremagic.com & giving me an opportunity to assist you.Wishing you healthy life ahead.Regards dear take care. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Why does everything get stuck on the roof of her my mouth? Patient:something in the roof of my mouth i noticed earlier that i have a piece of food or something lodged in the roof of my mouth its not very painful but i can feel it when i run my tounge across. i dont know if this is an emergency or if it can hold off for at least 16 hours. so can should i seek medical attention asap or can i wait this out? i really have no clue. [/INST] Doctor:hello thanks for consulting at hcm..some food material might have stuck in the palate region,, i suggest you do salt water saline,,also apply topical anesthetic in that area,,then again recheck whether you feel the food is still stuck there,, hydrate yourself well,, drink plenty of juices and warm water,,if still bothers you then you can take a consult with a oral physician,,nothing to very since it is not painful,,hope it helps,,take care </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes trace of blood in urine of a 14 year old? Patient:My 14 year old son had routine blood work and urine test last week. Just got the results and his liver enzymnes are at 65. Also, there was a trace of blood in his urine. We go back in for re-test in 3 weeks. What level of concern should we (his parents) have at this point and what reseach should we be doing? [/INST] Doctor:Hi,First repeat the exams. Look blood in urine could appear in health boys, there are some reasons for that like huge and strong exercises in the day or 1 day before the test, fever, some kinds of food, but may be the result of a bladder or renal infection, a stone. So repeat the exam if show blood again ask for a urine culture and renal usg. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What does large and giant platelet in the blood indicate ? Patient:My platelet count is 79 and occasional large and giant platelet found in blood .My total cholestrol is 7.7. What is the implication of it to my health? Also, what can I do about it? Thanks! [/INST] Doctor:Hi, Your platelet count is low and this can predispose you to bleeding from the nose, from the gums, under the skin ( in the form of red spots) and prolonged bleeding from cuts. The cause would need to be determined by doing a bone marrow biopsy. The treatment would depend upon the identified cause. Meanwhile, I would suggest you get a platelet count done weekly and totally avoid situations where you can get injured. Your cholesterol levels are high and this has been found to predispose you to heart disease and other diseases of the blood vessels. They need to be managed with a mixture of dietary interventions and drugs like statins. Please have a low fat diet with your saturated fat intake Exercise for atleast 50 minutes daily. This should be primarily cardiovascular exercise like walking, jogging, skipping or swimming. Speak with your physician about the need for statins like atorvastatin. Hope this helps. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest treatment for liquid oozing from umbilical cord in babies Patient:Question My 6 month old son has a naval point which is leaking a liquid which dries out to a white colour. The problem has persisted for 3 weeks and the baby has already been treated for infection with an antibiotic, but this did not help. Presently suspected is gall bladder complications. The general condition of the baby is normal except for this liquid coming out of his umbilical cord. Your advise on this will be very helpful. [/INST] Doctor:Good morning my dear ---your son most likely has a connection which was present in the embroyo which normally closes but can persist sometimes.This is called the omphalomesentric duct ----it can be a sinus,a cyst or a fistula---can be in connection with any internal organ and can sometimes contain a lining similar to stomach or intestine .Best is to check wit a pediatric surgeon who will make some ultrasound images and may give relief by surgically excising the connection.antibiotics alone may not heal and there will be recurrent discharge fronm the site. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: How to treat fever, shivering and hot sweats with dry cough? Patient:Hello my husband has been sick for 3 days now we had a dr come out day 2 and he said it was a virus and to keep up panadol and nurofan to help fevers and low temperatures. Day 3 and he slept on the lounge as he couldn t get up as he was to cold he was in warm clothes with 2 blankets on and shivering and then hot sweats. He has had headache sore muscles silvers (quite bad teeth chatter) dry cough exhausted for 3 days get worse at night. Please help [/INST] Doctor:Hi,It seems that he might be having bacterial infection getting bad cough and high temperature.He might require one course of antibiotic medicine course for 5 days.Continue giving panadol for fever, body ache till it controls with antibiotic.Give plenty of water.give him complete rest.Ok and take care. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What can cause pain in right shoulder and clicks in spine? Patient:MY ARM FEELS VERY RESTLESS AND WHEN DRINKING A DRINK WAS SHAKING THIS IS MY LEFT ARM,I ALSO HAVE RIGHT SHOULDER WHICH IS CONSTANTLY ACHING AND ACHES WHEN USED ALOT.MY HIPS HAVE ALSO STARTED TO FEEL STIFF AND I FEEL CLICKS IN MY SPINE,WHAT COULD ALL THIS MEAN?I ALSO GET SHOOTING PAINS THROUGH MY HEAD. [/INST] Doctor:Hello,Your symptoms could be suggestive of a bulging disc in the cervical vertebral column. For this reason, I recommend consulting with a neurologist for a physical exam and performing a cervical spine MRI.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Ilir Sharka, Cardiologist </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What are the uses and side effects of gabapentin? Patient:does gabapentin really help pain in lower back. My husband was put on that last week and so far, nothing! He fell 45 years ago and the five bones to the pelvis were like a spider web and coccyx (tail bone) was crushed. He feel 25 feet to the ground and landed on his tail bone with both legs straight. Then 8 years ago, he was moving a bath tub and he over corrected using a cart and it pushed him backward but he remained on his feet just pushed all the muscles backward. Now at age 72 he can hardly do anything, pain is so bad. He does yard work on his knees and can hardly get up out of a chair. Pain all of the time even when riding in a car? Will this Gabapentin help this pain? other pain meds have not worked. [/INST] Doctor:dear user, intake of Gabapentin helps reduce nerve pain, but also causes dizziness, drowsiness, nausea, or vision changes, swelling of legs and may also cause tremor.try to avoid it. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes thinning and loss of hair from scalp? Patient:Hi,Im an 18 year old female and my hair has been thinning for awhile now but it is starting to become very noticeable to where my hairline is receeding and my scalp is becoming more visible each day. So much hair falls out daily and doesn't seem to grow back. Almost all of the strands that fall out have a white bulb at the end. I also have hair growing all over my face which had not been there previously. I have irregular periods and I have acne. I have no health insurance right now but hopefully I will get it soon so that I will be able to get checked by a dermatologist. Ive been dealing with this for awhile and I understand that you are not able to diagnosis but what are the possibilities of it being? I would love to put name to it even if its not correct, for my sanity. [/INST] Doctor:Hello, I have gone through your query and you seem to be having a hormonal imbalance. Your hair loss and other symptoms seem to be due to polycystic ovarian disease or a thyroid disorder. I would recommend you to get thyroid function tests and ultrasound of the pelvic area. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Asmeet Kaur Sawhney, Dermatologist </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Low grade fever, rashes, blisters on chest, on arms and vagina, sun burn. How long will it take to clear up? Patient:I run a low grade fever not over 99 degrees temp at night, a rash with tiny blisters that started on my chest (collar area) then it spread to first my arms and external vaginal area, then my legs and now it is getting on my face - it burns, feels like a sun burn and looks like I have been scalded; I am retaining fluid where the rash is. This has happened in the past. This started in August, seemed to be about to clear up, and then this past weekend it seemed to start over but worse. [/INST] Doctor:Hi i think it is not a sunburn as unexposed areas are also involved.rule out immunobullous disorders.herpes infection.immunobullous disorders can be ruled out by biopsy and immunoflouroscence.whereas herpes can be ruled out by tzanck smear where u will find multinucleated cells.treat the condition with atarax 25 mg at night.antibiotic twice daily and use of wysolone 30mg tapered off to 10mg within one fortnight and application of gentisn violet for unruptured blisters and fucibet ointment for ruptured blisters </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest remedy for heart palpitations, profuse sweating and chills caused by depression Patient:I have been experiencing some heart palpitations, night sweat followed by chills. I feel depressed with a general not feeling well feeling. My head sometimes feels like something is moving around. Since Friday my right hand is on pins and needles. I ve been to the cardiologist been hospitalized with many tests run for heart issues with all negative results. My friends said it could be the effects of menopause plus I can t sleep at nights. Help [/INST] Doctor:Hi...Welcome to HEALTHCARE MAGIC...I have gone through your query and can understand your concerns...The mentioned symptoms in your query relates with menopause, as anxiety is one of the common symptom experienced by women going through this phase. It’s possible for anxiety and stress to cause physical symptoms, like heart palpitations, problem sleeping, cold or sweaty hands and/or feet, feelings of panic, fear, and uneasiness, numbness or tingling in the hands or feet and depression.I will advise you to make necessary changes in your life style like:-Start Exercising-Exercise releases endorphins and tires muscles, both of which drastically reduce your anxiety experience. Exercising, especially jogging is extremely important for managing anxiety.Avoid Stress-Avoiding stress is often easy to say and difficult to do. You can go for Common stress-management therapies like yoga, tai chi, biofeedback, guided imagery, and aromatherapy.Hope this information helps...Thanks & Regards,Dr.Shiwani </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest treatment for detached groin muscle Patient:Ok jan2 surgery for inguinal hernia also diagnosed with possible detached groin and or abdominal muscles yesterday i had for first time black specs sum bigger blackish brown eraser size peices also sum stringy stuff that looked like pulled pork or sumthin wich has not been eatin also bright red blood in a runny mucusy stool a little concerned as er did stool sample today and came up with nothing when i got home of course more blood and other contents [/INST] Doctor:hi,thank you for the brief history of you.since it is a possible detached groin or abdominal muscle and the possibility can also be less.what I will advice is to get the scanning done to rule out any of the possible factor of doubt. Also since you had an inguinal hernia surgery you should slowly start doing mild exercises to strengthen the muscles as to avoid any muscle wasting. start with breathing exercises like deep breathing and diaphragmatic breathing by placing the hand over the incisional area as to safeguard it.on a later stage you should strengthen the core muscles and the spinal muscles. Also to focus on the muscle of the hip and thigh to provide good stability to the joints involved.with the grace of God you will have a good health and recovery </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes lack of erection except in the morning? Patient:Hi dr I m 34 married 4 yrs back. I dont get aroused my penis does not get eraction not once in a day except in the morning i.e. morning wood. Generally after 10 days I get the feel to have sex. Sex thoughts come into my mind but still my penis does not eract untill I start foreplay but as soon as my thoughts are diverted I lose eraction. I cant keep up my penis eract even for 1 min. I have to start sex right after I get eraction. I want to know whether I m suffering from ED or something else and what are the causes and cure for my problem. plz help me. [/INST] Doctor:DearWe understand your concernsI went through your details. Please do understand that most of the erectile dysfunction problem are due to stress and anxiety and obsession. In your case too, I suspect the same because you do have erection in the morning. The details you gave in the query are not enough to diagnose your anxiety problem. You may consult a psychological counselor or sexologist who will advise you more on this aspect.If you require more of my help in this aspect, please use this URL. Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications.Good luck. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Diagnosed with polycystic kidney disease. Blood pressure under control. Can it be cured by kidney transplant? Patient:My husband was diagnosed with polysistic kidney disease 3 yrs ago...I hear there is no cure for this...just control blood pressure which he does with medication.....his kidney function is 30..he is 49 yrs. old why cant they offer him a transplant. I understand this disease causes all sorts of other problems...what can you suggest [/INST] Doctor:Hello.When polycystic kidney causes problems in blood pressure and renal function (elevation of blood levels urea and creatinine) the solution is transplantation.The transplant cured but is necessary to get a compatible kidney to her husband, all kidneys are not useful for any patient.I wish you good health.(if the answer has helped you,please indicate this) </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What are normal blood sugar levels? Patient:I am a 62 year old male with type 2 diabetes, since gastric by pass surgery I am no longer hyperglycemic but, I have episodes of low blood sugar now. What is a healthy blood sugar level? right now my blood sugar is 86 and I am sleepy and yawning, yesterday I was sleepy on the road to work and when I checked my blood sugar it was 70 but, I perked right up when I had a diet supplement milkshake. [/INST] Doctor:Hi thank you for querry,As there is diffrent blood sugar levels in fasting condition and 2 hours after food.FBS is taken in fastong condition it should be 60 to 110.After food its RBS should be below 180 in diabetic patients.you should regulate your sugar level.Take food and snakes at proper time with life style modification also.consult your Dr.in case of severe hypoglycemic attacks or hyperglycemia or in case of any complication regarding medication and sugar level.Hope the answer will help you.wish you a good health. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What are the complication with Strep B? Patient:My daughter is 2 years old, almost 3 and she was told by her doctor that she has group b strep. How did she get this? I do not have step b. I was tested when I was pregnant with her and it was negative. Also, she was delivered c-section. Will she have any complications through life? And will she always have step b? [/INST] Doctor:group b streptococci are usually not harmful at this age group. they live normally on body surface and certain body cavities. these sometime cause disease such as pneumonia, meningitis which needs treatment. so u need not to worry. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes high creatinine level after a nephrectomy? Patient:Hello, thank you for taking the time to do this! My dad had a nephrectomy done about 3 weeks ago. Creat next day post op was 1.5, next week was 1.6. Yesterday was 1.8. Ultrasound being done tomorrow. He does have prostate issues also and is on flomax for this. Is it normal to have a higher creatinine post op? [/INST] Doctor:Hello, yes after a nephrectomy sometimes s. Creatinine goes up. That is beacuse after removal of a part or a total kidney the other kidney has to work and compensate for the removed one. It will usually increase in size to compensate. Creat levels are found to go bit higher after surgery but in a matter of 3 to 4 weeks they come back to normal levels. So i would suggest let him undergo the USG tomorrow and wait for 2 more weeks for creat to come to normal. If it doesnt then you need to see the nephrologist. Thank you </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes white slimy layer on the penis head? Patient:i have a white paste like substance on the head of my penis. I pulled my finger across the head and it almost looked as if a layer of skin was peeling it off. I am circumsized but when I pulled the skin down all the way I could see it was in there as well. What is this? [/INST] Doctor:DearWe understand your concernsI went through your details. The off-while slimy paste like substance you are witnessing on the head of your penis is a mixture of urine, sperm and semen and dust and sweat. That will be cleared if you keep the area neat and clean. Keeping the area clean is the remedial measure and comes under personal hygiene. If you require more of my help in this aspect, please use this URL. Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications.Good luck. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Does high BP cause dizziness and spinning sensation? Patient:Hi there, I am 33 overweight female with high blood pressure, have suddenly developed tingling feet and hands while lying in bed and having weird head spins. Am on blood pressure medication and currently on weightwatchers losing an average of 1 kilo a week. Should I be concerned about tingling in hands and feet [/INST] Doctor:Hello, 2 things I would like to recommend. 1) Keep a tab on blood pressure if you have a machine at home . Make sure that the blood pressure is well under control with medication . A slight variation in comparison to normal self may result in all symptoms you describe. 2) see which medication you are taking for reducing weight . Most of they have a lot of side effects which include an increase in blood pressure which may cause headache and tingling . An exact information on the medication will help me be more objective . However if your blood pressure is normal and yet you are having symptoms , Stop the weight watcher medication . Hoping I could help . Regards Dr. Priyank Mody </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes recurring swelling in feet? Patient:I am curious why my feet get swollen every now and again, though i do regular exercise, am not overweight and it happens like 4 times a week. They are often okay when i wake up in the morning. I work from home and try to keep my feet elevated and move around regularly. [/INST] Doctor:Hello, I think you should get the scanning for the kidney and also the heart done. Due to reduced venous return, the swelling can be there. There is even the possibility of the kidney malfunction leading to swelling. Until we check the physiological status of the heart and kidney we cannot give you an accurate cause for it. As with respect to swelling, there are multiple factors associated like heart conditions, kidney conditions, diabetes, etc. Until we have some clinical platform and lab reports it will not be fair on our part to make you panic. Get things examined by the laboratory so we can assist you better. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Q. Can I use Ashwagandha or Shilajit for fatigue caused by masturbation? Patient:Hi doctor, Earlier in my life I had the problem of over-masturbation. This was related to my mental depression as well. However, I have recovered from the habit of over-masturbation. But, still I masturbate once in four days. This causes fatigue, back pain and leg pain. Can I use supplements such as Ashwagandha or Shilajit for the same? What is the recommended dosage? Which is better Ashwagandha or Ginseng? Which variety of Ginseng is good? Also can I use supplement for my mental depression such as Brahmi or Ginkgo biloba? Which one would be better? I am overweight. I have borderline cholesterol and slightly fatty liver. Further I am already using psychiatric medicines for depression and obsessive compulsive disorder. Apart from this I am using Omega 3 fatty acid and Liv 52. I have attached herein my recent blood reports for your reference. Thank you. [/INST] Doctor:Hi. Revert back after three months to an ayurveda specialist online --> </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Pins and needles sensation in chest. Taking flovent daily. History of asthma. Causes for symptoms? Patient:Hello, My son today has been complaining about pins and needles in his chest . He does have Asthma and takes flovent on a daily basis as a preventative. He complained that he had it at school for only a few short times and now this evening he said he had it again. It moved from one side of his chest to the other. Do you think this is related to his Asthma? What could this be a sign of? I have read a few things on-line it may have to do with his heart? [/INST] Doctor:sometimes the preventors are not able to prevent the symptomps you can add antiallergy ca add montelucast safely 5 mg tds for 2- 3 week you can add liquid antacid ulgel 2 tsf tds to counter any effect of reflux which can also present with this kind of symptomps </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: My younger brother got sudden fever & felt difficult in moving his both legs Patient:My small brother got sudden fever past 1 weeks ago after playing football in rain.at evening he complains of fever but nobody cares him as they think that boy was just bloffing.The next day child feels difficult in moving his both leg and hands.He cannt even make a stronger fist.after few days.. his leg started geting some improvement and walked but with mild awkward gait.he complaints of pain in aand around neck and shoulder blade plus back pain too. He got treatm,ent of acupuncture also but no recovery of his hand fnctions. He cannt even squeeze the exercise ball. I am very worried wht happened to my brother, Doctors told him its only weakness of lims thats all.can u plz tell me what might happened to my brother. He is of 15 years old boy. [/INST] Doctor:Hi,Ramesh, Thanks for query, it seems he might have influenza causing severe bodyache,sinusitie causing pain in eye ball. Go for blood test for TC,DC,ESR,Platelet counts. After reports go for treatment accordingly. Give plenty of water,light diet. Ok and bye. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes severe pain in backbone? Patient:how are you? long time already i have problem with my backbone and i have a treatment one year but my heart still the same it just reduct little bit. i still heart , my muscle paint 4-5 i was scanned already and i want to operators but i afraid the result . so i need your common . sorry my English not i can explain more anything that i want to tell you please help me i felling i lost haft of my life already.regard you piden from cambodia [/INST] Doctor:Hello, Thanks for your query.From description it seems you might be suffering Mechanical back pain.     It is a common medical problem.Mechanical back pain implies the source of pain is in the spine and/or its supporting structure. The surrounding muscles and ligaments may develop reactive spasm and pain.1. Lie on hard bed2. Taking muscle relaxants in combination with mild pain killers will help you.3. Hot water fomentation to back 2-3 times a day and applying a local analgesic gel on the affected area will also help in providing a relief.4. Physiotherapy - Interferential therapy (IFT) to your back will help you relieve the pain5. Avoid driving, leaning forward, sitting for prolonged time or lifting heavy weights. These activities can increase your back pain.You can start with swimming and mild aerobic exercises. These do help a lot in the back pain. Do adequate warming up before starting the exercises daily.Taking calcium and vitamin D 3 supplements will also help in early recovery. You can get these prescribed from your orthopedician.I do hope that you have found something helpful and I will be glad to answer any further query.Take care </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Can tuna and corn cause allergic reactions in a child? Patient:i just noticed blister looking bumps on my sons neck, (front and back of the neck), and a small one on both eyes, and one on his mouh. I just found out he was given tuna, at his 1 year bday party, three days ago, and baby corn caserole, he has never tried any of these things before. Could it be an allergic reaction to the tuna, and corn? [/INST] Doctor:Hello,I can understand your concern. Yes, there is a chance that the child is allergic to either corn or tuna. I would advise you to visit a pediatrician for the prescription of the antihistamine to control the allergic reaction. If the ulcer in the mouth is painful, you can apply local Benzocaine gel over that such as Mucopain, 3-4 times in a day.If he develops recurrent episodes of such allergic reactions, you should go for a blood test that evaluates what substances the child is allergic to so that the exposure can be avoided in the future.I hope this information helps you. Thank you for choosing HealthcareMagic. I wish the child feels better soon.Best,Dr. Viraj Shah </s>

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

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What are the treatments for recurring itchy, red rash on wrists? Patient:I have a reoccurring rash on the insides of my wrists. It's read and itchy. I used to wear jewelry but stopped. I do use essential oils and thought this might be the reason. But I am not applying to the effected area. I'm not so concerned a bout what it is (but am curious) but how to stop it. [/INST] Doctor:Hi, It could most probably due to jewelry, the condition is known as contact dermatitis. Does it resolves after stopped wearing the jewelry. In that case, the diagnosis is most probably contact dermatitis. Do visit your Dermatologist to confirm the diagnosis and to initiate the treatment. Hope I have answered your query. Let me know if I can assist you further. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Q. Why is my brother weak after stopping alcohol? Patient:Hi doctor, My brother is suffering from extreme numbness and pain in soles and palms. He also experiences constipation, weight loss, dizziness and lack of appetite. Please help. [/INST] Doctor:Hello. I had gone through the data you have posted. For further information consult an internal medicine physician online --> </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes low back pain,hot sensation,nauses,vision loss with headache? Patient:I bent down to pick up my daughter and had immediate pain in low back, hot sensation up back, sick to stomach, loss of vision for about 10 minutes, bad headache, legs weak, and tingling in face, top of head, back of head. I did this a week ago and still experience tingling in head and face. My iron was 9.1 and blood test came back normal. [/INST] Doctor:Hello, I have studied your case. There is possibility of transient ischemic episode leading to pain in your back and loss of vision temporary. You may need clinical examination to confirm neurological weakness, BP and other vital parameters. Another probability is due to compression of this nerve root there is pain in your back.You may require MRI brain and spine.For these symptoms analgesic and neurotropic medication can be started.Till time, avoid lifting weights, you can consult physiotherapist for help.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Gum swelled, Gums around tooth have receded, rinsed with salt water and flossed, had appointment, any suggestion? Patient:3 days ago my left back gum swelled up and hurt, so I rinsed with salt water and flossed and it felt better. However, the gums around the tooth have receded quite a bit and the inside feels like it has been cut and like there is something stuck deep under the gum. I have at least 2 cavities on the tooth and have a dental appointment scheduled for 1 week from now. I also have a doctors appointment in 2 days. Is there anything else I can do? Should I be receiving more urgent care? [/INST] Doctor:Hi,Welcome to the forum,According to your clinical symptoms i suppose that you have developed infection in your tooth that had spread to the periapical tissues.A thorough clinical examination by the Dentist is required.Get the x-ray done of the infected tooth based on which it can be filled using restoration or can be root canal treated.Get complete mouth scaling polishing and curettage done.Take lukewarm saline and antiseptic mouthwash rinses.Gingival recessions can be treated using periodontal surgeries.Take care!Regards.. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes recurring diarrhea and vomiting in a child? Patient:Every month or so my 13 year old son gets major diarrhea and vomits once. He does not run a fever during this time. He also complains of having a rotten egg taste in his mouth or of burping rotten egg taste. What is this and why does it keep recurring? [/INST] Doctor:dear userabout your question i would like to tell you that recurrent diarrhea has some causes in this age of your son.......allergy to food cause the intestinal movement to increase rapidly so causing diarrhea and vomiting.......so you should notice if there is food that if he eat symptoms increase to avoid that food second if your son had intestinal infection of the past or had severe gastroenterities that may cause damage of intestinal epithelium and so maldigestion and recurrent diarrhe occur and it will need some time to improve gradually as it is self limitedif your son eat unhealthy food or fatty food or spicy food that may cause these symptomsalso you should do stool culture for him and widal test to detect if there is salmonnela infection causing typhoid or another intestinal infectionas the intestinal infection viral or bacterial should be managed to end of this problemhope that helps youi wish you and your son happy life </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes cold fingers/toes and piercing pains in joints? Patient:Hi I am a college student, currently on holiday.... Lately I have been sleeping very irregularly. For instance if I wake up in the morning within the space of 4-5 hours I will feel drowsy and fall asleep... I also have cold fingers and toes and piercing pains in joints... I was told my vitamin d levels are critically low. [/INST] Doctor:Hello, You should sleep 8 hours during night and take vitamin d supplements to reach the normal level. Also walk in fresh air and eat healthy. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Blerina Pasho, General & Family Physician </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes itchy rash on the torso, back and neck of a toddler? Patient:my 3 year old has a rash covering her torso, front and back, also her neck. It didn t get to her back until yesterday and this morning it has went further down her back. I have been putting hydrocortazone on to relief the itch. she has had a minor cold the past week but is no longer sick now. But she is with a rash. what could it be? [/INST] Doctor:Hi, It is probably a viral infection that need to be seen by a pediatrician, but at the mean time, you can continue on cortisone. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Salah Saad Shoman, Internal Medicine Specialist </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest treatment for severe shoulder pain Patient:Ok, yesterday I starting feeling like I have a cramp in middle of my chest, but it is very mild. Sometimes I don t even feel it. I notice if I crouch my shoulders forward I feel it, but not so much when I pull my shoulders back. So I was thinking it may be gas in my chest??? So what do you advise? [/INST] Doctor:Hello, I have studied your case.According to your history and complains such kind of pain can due to compression of nerve and muscle sprain due lifting of heavy bag/gym on shoulder.When such patient comes to my hospital we usually take x ray spine to see for severity of nerve compression.Another differential can be nerve compression due to disc bulge which may need MRI for confirmation.Medication like methylcobalamine with muscle relaxant and analgesic will reduce pain; you can take them consulting your treating doctor.You may consult physiotherapist for further guidance. He may start TENS, or ultrasound which is helpful in your case.You may need to take rest for early healing.I will advise to start antacids [proton pump inhibitors like] rabeprazole 20 mg twice a day for gastric trouble.Sucralfate will protect gastric mucosa and will give protective covering.Gastric hyperacidity can lead to altered mouth taste.You may need to avoid acidic food like bakery items, smoking, alcohol, cheese, stress.Eat fresh food and soup with fruits juices.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take careRegards Dr Vaibhav </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What could the bump on thigh be indicative of? Patient:im 23 weeks pregnant, i dont know if this has anything to do with it, but last week i noticed a small bump on my inner right thigh, its hard and it hurts, this week it has only gotten bigger. i'm afraid it might be some serious but dont know what to do can you please help? [/INST] Doctor:Welcome to health care magic. 1.There are tow possibility according to your history. First is lymph nodal enlargement which is seen in localised or systemic infection / inflammation.2.Second is vascular cause which can be suspected in pregnancy like venous insufficiency causing bulges.3.Finally localised infective aetiology with collection of pus - hair follicular infection.4.It need to get examined and a ultrasound scan will help to know the nature of the lump and its source and extensions.5.So get an appointment and get treated. Good luck.Hope i have answered your query.Any thing to ask do not hesitate Thank you. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes blood in stool of a child? Patient:my baby is 14 month old, from five days passing hard stool.one day i noticed red blood in her stool.at the time of passing stool baby is crying.baby is taking junior horlicks from two months before. and also regulary taking pure cow milk everyday along with mother breast feeding.we are very afraid to see the blood in her stool. [/INST] Doctor:Hello,Hard stool ate often accompanied by bright red fresh blood in children. Blood appears only in hard stool and not in the soft stool. Increase her fluid intake. If her constipation is cured then give her a mild laxative for a few days. Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Varinder Joshi </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Is Tocoxid EC and Razep IT cap the only treatment for mitral valve proplapse? Patient:Hi Dr.Gopi,This is Beemarajan from Singapore. i would like to ask some thing about MVP(Mitral Valve Prolapse)i was having some pain on left side chest for more than 45 days. then i went to consult Dr. Alagarasan,Thanjavur,india, he had taken the echo,he said nothing major problem on your heart,it is some valve goes in and comes out.(from the report i came to know that i have MVP problem) he has advised to take these tablets( TOCOXID EC 400mg,RAZEP IT CAP).when i take these tablets i dont feel any pain.he asked me to take these medicines for 2 months.after completing 2 months again after some days i feel the same pain. now i am taking the same medicines.if i stop taking medicines i feel some pain on my chest. do i need to continue full life time or is there any treatment for that?Please advice.Many thanks [/INST] Doctor:Hello SirMVP diagnosed in the early stages is not much of a problem. Once the disease progresses maybe 1 or 2 decades later then it might require surgery which is the definitive treatment.rest, the medicines that you have been taking are not specific for this disease entity but if you are feeling good after taking them then you can continue doing so </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Headaches, red and yellow discharge from nostril, jaw pain, illness. What is going on? Patient:Hi, I have a very bad headache as if my head is going to explode. Reddish yellow discharge from my left nostril , clear discharge from my right nostril. My eyes are watery and paining from inside. Also, I have upper jaw pain and general feeling of illness . I am currently using over the counter medications, but cannot get relieved. I cannot sneeze too hard because I am getting blood from the nostril, But if I dont, my nose is getting stuffed up and I cannot breathe. I recently got the cold, got rid off it and after 2 days, I got this problem. Can you please suggest me something? Thank you [/INST] Doctor:Hi, Welcome to HCM, From your history it suggests that you are having acute rhinitis with sinusitis. Go for antibiotic medicine, decongestant medicine like Diominic DA and some anti-inflammatory medicines. Put some decongeatant nasal drops in nostrils. Apply antibiotic cream in the nostrils. Go for Vicks vapor inhala tion. Avoid cold drinks, fried and junk food. ok and bye. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest remedy for swollen lymph node Patient:I have recently noticed that i have a swollen lymph node on the bacl left side of my neck. you cant see it, i noticed it but palpating the area. it does not bother me other then the fact i know it is there. i have no other symptoms. my parents say they cant feel it however i can. it also kind of feels like a muscle. but there is not one on the other side [/INST] Doctor:Hello, As your lymph node is asymptomatic please get its fnac done to reach upto a proper diagnosis for treatment. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Jaideep Gaver </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes white discharge from penis? Patient:Hi sir this is Rahul 25 i have been in relationship with a woman from past 4 years single partner recently i had unprotected sex with her i trust her i had sex with her i noticed a symptoms of white discharge in penis and pain during urination for 3 days i consulted my general physician he took HIV test and hbsag test everything found negative he said i hav pus cell of 2-4 so i'm suffering from UTI he prescribed me few medicnes now discharge have stopped but still i panic tat i have STD please help [/INST] Doctor:Hi, These symptoms and signs are suggestive of STD especially if there is associated with pain, fever, urethral discharge, and recent sexual intercourse. So this is the first thing to rule out by doing STD testing. Second, it may be a sign of uroinfection or urinary stones and some other genital infection but this is less common. In every case, antibiotic therapy may be required so the test should be done as soon as possible so that appropriate treatment can be started. Till that try to drink plenty of fluids, avoid sexual intercourse and rest. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Ivan R. Rommstein, General Surgeon </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest remedy for dog bite Patient:Hi, may I answer your health queries right now ? Please type your query here...My two month old puppy is very playful and active. He scratches and bites while playing. He was bought from a nice family having a male and female dog and the puppy parents have been vaccinated. I have a small scratch mark in my hand with little bit of bleeding. Would like to know whether i would have to take anti rabies injection. Should i take the vaccine everytime he bites. I have a 12 yr old son who loves the puppy and iam very worried about him being bitten/scratched by the puppy [/INST] Doctor:Hi,Welcome to HCM.I understand your concern about you and your son getting scratched by your newly acquired pet. It is not necessary to get rabies vaccine if the vaccinations of the puppy are complete. However, make sure you clean the wound thoroughly with soap and running water. Also make sure that your pet gets vaccinated regularly. Training of the pet is also necessary to avoid accidents at home especially with young children.Thanks. </s>