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<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: How can pain and bruising in knuckles be treated? Patient:My right knuckle started hurting without hitting it and I looked down to see a bruise there all of a sudden and as time passed, not only this the bruise and pain spread, but the left knuckle started doing it. My right pinky is starting to tingle as well. Thoughts? [/INST] Doctor:Hello, It might be due to minor trauma or abrasion that may have gone unnoticed. As of now, you can apply ice packs for symptomatic relief. If symptoms persist, it is better to consult a physician and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What could be causing chest pain? Patient:Age: 15 Height: 5'10" weight: 156 Just 2 weeks ago i've experienced chest pain. I never had chest pain before, so i went to the doctor and he told me it was respiratory(i have asthma) related because I my heart sounded fine. Why is it that i'm feeling this for the first time in all of my life? [/INST] Doctor:Hi thanks for contacting HCM...When allergen exposure high and your immunity low , infection can be there...And viral infection can lead asthma attack ...Your first step is to confirm asthma....Your ECG normal ....no heart problem present as per your history....Spirometry , pulmonary function test done for it...Now if asthma confirmed or allergic reaction then try to avoid exposure to allergen like dust , pollen , environment pollutants etc.....Smoking avoided.....If no asthma then pain can be by bronchitis like condition....For congestion relief steam inhalation and antihistaminic useful....One tsp ginger with honey is good herb remedy....Remember auscultation respi examination is having utmost importance that guide further investigation....If repeated asthma attack occurs then metered dose inhaler can be started with salbutamol sos when needed.....Take care....Dr.Parth </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes leg tremors, lower back pain and muscle spasms? Patient:I suffered a work accident oct 2015..they said it was a back sprain..had mri , cortozone infiltration , physioterapy ect...still have lots of pain as of july 2017 suffering with a very shaky leg, fell down twice once down the stairs,once pushing lawn mower cause my leg just seems ro give out. If i sit to long having a hard rime getting out of sitting postion bottom of my backbone feels like it's on fire..ans the muscle spasmea omg !!!!!! Please help [/INST] Doctor:it sounds like you are having progression of your disease. I would recommend getting repeat imaging. the weakness and falling down it's concern. you should get evaluated by a surgeon and MRI </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: How can lower abdominal pain and nausea in a child be treated? Patient:My 9 yr old granddaughter has lower stomach pain. Went to drs and said she was at start of ulcer, gave meds for ulcer, and nausea. But she still complains constantly of nor feeling good. I'm at a loss . I don't know if she is actually NIR feeling well or wants attention. Please help. [/INST] Doctor:Hi, Unless there are red flag signs like - green or bilious vomiting, incessant vomiting, blood in stools, blood in the vomit, rash, joint pains, seizures or family history of renal of gallstones - you need not worry about the pain abdomen. The possibilities are - 1. Mesenteric adenitis. 2. Attention seeking behavior. Hope I have answered your query. Let me know if I can assist you further. 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. 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 causes itching in hands and feet? Patient:Hi, I hv developed itchy hands and feet over the last 20 days...hv taken medication for worms and allergy too.but the medicines only seem to help till the time the prescribed dose is completed....thereafter itching starts again and is also spreading to rest of the body....can u advise what could be the reason and remedy [/INST] Doctor:It might be due to scabies most probably. For treatment you can use scaboma or calamine lotion for local application stat at night after taking bath with warm water along with avil or cetrizine for itching. You can take cap zevit or cap metilda-forte once daily in afternoon along with tab bandy-plus one stat at night than after 7 days. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes rib pain with shortness of breath and popping sound? Patient:I am a rower and began experiencing rib pain the other day. I m pretty sure nothing is broken, but where the rib connects to the sternum I have a lot of discomfort. I am a little short of breath and there is a popping sound. It is painful when I move and am laying down, but is not painful to the touch. [/INST] Doctor:Hi, As this sounds like a costochondritis. The joint where it is painful is the costochondral joint and it is due to strain happened there. I will advice to not to activities which leads the joint to be more in strain and also allow the joint to relax more. Do hot water fermentation and slow deep breathing while supporting the joint over the chest and wait and see if the pain reduced. Also an x-ray will be of good choice to look out for. 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: Suggest remedy for persistent sharp pain in lower right abdomen Patient:I have a persistent sharp pain in my lower right abdomen. Suffered blunt force trauma (lacerated liver) about 8 weeks ago. Could the pain still be attributed to the accident? If so, how long until the pain goes away? Are there any additional concerns with regards to the pain? [/INST] Doctor:Hullo and welcome to this forum. Pain radiating from liver is usually referred to "upper" part of right abdomen pain in lower right side of abdomen may be due to appendicitis, which is a surgical emergency, or colitis, infection/inflammation of the colon. Do consult a surgeon immediately without further delay. </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 the mild case of mouth thrush? Patient:I have been diagnosed with a mild case of mouth thrush but, I cannot find the mouth wash my doctor prescribed for me. If I am spelling it properly, it is fluconarole the doctors penmanship is terrible. Hopefully you can help me. I cannot pay even your modest fee. I have small cell lung cancer, but on limited SSI for household bills only. [/INST] Doctor:Hello,The medication is called Fluconazole. Diflucan is the US brand name of a tablet that is swallowed . The medication is available by prescription. Dosage and length of use is determined by your doctor. This can vary and must be confirmed for your circumstances. Fluconazole may be given as a liquid, tablet or capsule. For oral thrush, popular alternative rinses or lozenges, are Clotrimazole, Nystatin, Itraconazole and Ketoconazole. There are combination solutions called "magic mouth" that vary in composition with an anti-fungal medicine, anti-inflammatory medicine and possibly pain medication to help treat thrush and provide symptom relief.Concerns with other medications you may be taking must be considered. I see you have a condition with cancer. You must confer with your doctor to follow the medication as directed. The pharmacy can clarify all details with the doctor and will clearly label the medication with instructions.Thank you for contacting HealthcareMagic. I am glad to offer further assistance and hope you will be able to fill your prescription soon. I hope you find my information useful. Iam sorry, but I do not know your location to make recommendations on cost saving locations for this medicine. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What can cause tingling and burning sensation around the ankle? Patient:Last month, I woke up with a tingling along my inner ankle. It has progressively worsened to burning pain. Just yesterday, it spread to the heal and the pain doubled to where it hurts to walk on it. If I take NSAIDS and stretch, I can walk, but not comfortably. [/INST] Doctor:Hi, You may be having plantar fascitis. In this condition there is inflammation of the calcaneal tuberosity. Calcaneum tuberosity bears weight of whole body so you get pain on walking and weight bearing. Treatment is use of soft heel cushion and soft slippers. Ankle stretching exercises in morning before getting out of bed and hot wax bath helps in pain relief. Tablet Ultracet P twice a day can be taken for pain relief. Visit to orthopedic surgeon for detailed clinical examination is recommended. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Jayesh Vaza, Orthopaedic Surgeon </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes inflammation around injection site after getting vaccinations? Patient:My son was born 8/22/08 and during his scheduled appointment on 10/22/08 he received his vaccinations DTAP-HEPB-IPV, HIB-OMP, DTAP-HEPB-IPV. After getting home I noticed the injection site was inflamed and red and disregarded it as normal injection side effects and did what doctor told me to by warm compresses and rubbing it.It started off as a red spot half the size of a pea. To this day it is still there and has grown as he has grown and is now the size of a nickel.It flares up from time to time and looks almost like a hive at times and itches and swells up to the size of a quarter or half dollar. Frustrated,I can not figure out what this is.Any suggestions? [/INST] Doctor:It is most probably a foreign body reaction, caused by the injection. It is increasing in size with the growth of the child. If it is causing any symptoms it needs to be removed, usually it is symptomless. To confirm get a ultrasonography done. Also check on the immune status of the child, get Hepatitis B antibodies (HBsAg) done. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Have breast ultrasound report. Can any online doctor help me to read it? Patient:hi, i just got to know from my breast ultrasound reports that i have a well defined cystic area measuring approx. 4.4mm. is seen in the dermis layer of the sin of the left axillary region. both breast show predominantly fibro grandular parenchyma. there is no evidence of any Sol/ Architectural distortion/ calcification . both nipple, reteroareolar region, skin,subcutaneous tissues and axillary tail region are normal. i am 23 years old female and i went to the gynaecologist yesterday in order to check if i had breast cancer . i was very scared because from last 4 months i had some pimple sort of thing on my left underarm . also i felt some burning pain on my left breast and on the underarm too. i also have spondolysis symptoms so i have the pain on th eentire left side. please tell me is it related to any cancer. i am very scared. [/INST] Doctor:Dear Ma'am,Sorry to hear about your problem. The breast ultrasound report appears to be absolutely normal. The pimple which you have described under the armpit (axilla) is probably an infected sebaceous cyst (infection of the hair follicle) and will subside with time. If it is inflamed and not settling, you can take a course of antibiotic. There are no symptoms suggestive of cancer but you should continue to do breast self examination regularly.Hoping for the best. Dr. Rohan KhandelwaBreast Surgeon </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What are the repercussions of pulling an abscessed tooth? Patient:Hi I had a abscessed tooth that had broken in half vertically , I went to the dentist in pain and thought I would get antibiotics at least for a week, I have always heard it was dangerous to pull a abscessed tooth. It was pulled on Tuesday and I am wondering if the infection could have gotten in my bloodstream , I am really tired and have no energy, Just doing little things around the house I get short of breath, [/INST] Doctor:Hi Dear,Welcome to HCM team.Understanding your concern. As per your query you had extraction of abscessed tooth which could leads to spread of infection at times if not done properly as it is always advisable to have proper course of antibiotics to subside infection and then go for extraction.I would suggest to do warm saline rinses or baking soda rinses 3-4 times a day ,they will be very helpful in relieving symptoms. You should visit dentist once and get complete examination done and go for X-ray of tooth to detect if any fragment of tooth chip is there. Start proper course of antibiotics along with antiinflammatory medications for faster healing. Maintain hygiene.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: How to get pregnant if suffering from irregular periods? Patient:irregular period we want child. our doctor had given fertyl tablet.please answer me. [/INST] Doctor:HiGREETINGS First of all we have to rule out the causes for irregular periods.Hormonal analysis esply thyroid ,prolactin along with an ultrasound scan to rule out PCOD will be initially useful in finding out the reasons for irregular periods.Once the cause is detected it can be treated or controlled with medicines and fertility can be assisted.So. Hope my answer helps you. Regards </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Will it be difficult to get pregnant after a prolong use of loette tablets? Patient:i have taken loette tablets for 2 yrs and frm last 1 yr i have stopped, now willing to get concieved i have undergone Hsg test as well, now i have got a ist period after my HSG, i am now in confused status, i am scared whether i will get concieved or not [/INST] Doctor:Hi there Please do not panic. If you have regular cycles, your fallopian tubes are patent and partner's semen reports are normal then you need not worry about the pregnancy. Low dose contraceptive pills do not have any negative impact on getting pregnant. Please start on Folic acid, Vitamin B 12 and Omega 3 supplements at least 3 months before you plan to get pregnant. As you might be aware that in a woman with regular cycles day 10 to 20 of the cycle is the most fertile period of cycle. If you happen to have unprotected sex act in this period, then You Stand chance to get pregnant. I hope this answer helps you. Thanks. Dr. Purushottam 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 treatment for green loose stools with low grade fever? Patient:infant 8 m.;healthy active .c/o freq [7-8]of loose motions-greenish semi solid-occassionaly watery;low grade fever;caterrh-cough;no vomiting-apperent dehydration.what should be line of rx especially anti ameobicidals/antibiotics if required.----indian standerds. [/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: Suggest treatment for recurring urinary infection after prostrate operation Patient:after prostrate operation my husband is constantly suffering from urine infection by the bacteria like klebseiella,staphylococcus,e-coli etc He had been treated with netromax, injeetin amitax, tab lino , but still now he s suffering from ecoli .Kindly suggest me what to do [/INST] Doctor:Dear I can understand your concern . I would like to inform you that after prostate surgery and foleys catheterisation it is very common to get urinary tract infection . This should be properly assessed and diagnosed . There are so many bacterial infection that can c use them. It is very important that proper urine culture should be done and antibiotics are chosen depending upon their drug sensitivity pattern. These days we are noticing increasing prevalence of multiple drug resistant bacterial infection . So proper diagnosis and dry sensitivity has to be determined . Hope this will help you . If you have any other concerns please feel free to message me . Thanks for contacting HCM . </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: How to stop growing of septated anechoic mass in liver? Patient:my liver is with homogenous parenchymal echogenecity. a septated anechoic mass is seen at segment 8 of the right hepatic lobe measuring 3.1 cm in diameter. what shall i do in order for me to stop this from growing or to get rid of it? thanks and GOD bless. [/INST] Doctor:HIThank for asking to HCMI really appreciate your concern looking to the history given here I would like to say that, without knowing the exact nature of growth in your live it is difficult to say anything moreover the entire management of this lesion would be depend upon the type of lesion and for that you have to get done some important test, like biopsy CT thorax, these test would clear then diagnosis, hope this information helps you, have a nice day. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: How can I improve my skin tone ? Patient:r when i was born but gradually my skin became dark and my face is brown in colour i want to became white so is there any tips for becoming whiter especially any creams hello doctor i am 17 years old boy and my name is kamal i was whiter when i was born but gradually my skin became dark and my face is brown in colour i want to became white so is there any tips for becoming whiter especially any creams??? i have dry skin type..... pls doctor help me [/INST] Doctor:hello kamalwelcome to health care magicthere is no such cream which will bring bck ur complexion if at all any is just on temporary basis.take care of ur diet.drink plenty of water.apply sun protective creams while going outside and wear sun glasses.have food rich in vitamins.take fresh fruits and juices.vitaminC rich foods like amla is good for skin. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: How to interpret renal tract ultrasound result? Patient:Hi Doc, I'm 66yrs.old,and just picked up my Renal Tract Ultrasound result. The conclusion is :- 1. Mild prostatomegaly and 2. Mild post void residual 36cc. Can you please advice whats this all about, as I can't see my doctor till late next week ?? Is this a serious condition? Many thanks in advance. Tony from Doununder. [/INST] Doctor:hai,As your ultrasound result indicates prostate gland ( gland which lies on either side of the urethra) enlargement. it is common in every men aged above 60 years.Mild post void residual 36 cc indicates retention of urine in your bladder after urination.prostate gland enlargement (prostatomegaly) will cause urinary retention and urinary incontinence.this is not a serious condition to address immediately.Thank youhope i answered your query </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Ultrasound shows bilateral renal parenchymal disease, fatty liver. Suggestions? Patient:my mother is 64 years old in ultrasound scaning report is showing right kidney 94X37mm,Left Kidney -90X44mm. Both kidenys are normal in size with increased echotexture. collecting system is normal no evidence of calculus is noted impression: BILATERAL GRADE-1 RENAL PARENCHYMAL DISEASE GRADE-1 FATTY LIVER pleae advise [/INST] Doctor:Hi Thanks for your query. Bilateral renal parenchymal disease suggests kidney disease. This could be seen if your mother has long standing diabetes or hypertension. The appropriate tests to do would be urine analysis and microscopy and serum creatinine. Further investigations and treatment will be as per the results obtained. A nephrologist would be appropriate person to consult Good luck </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Will she get pregnant even after taking unwanted 72 after sex? Patient:hi sir, i had sex with my gf and after 48 hours of sex i had given her an unwanted 72 pill it is almost six days gone but her period has not came yet. it is after 20 days of her period i had sex with her. i am afraid if she is pregnant.. please help sir. [/INST] Doctor:Hello dearI understand your concernChance of the pregnancy is very less because1. You dis sex 20th day of the period and it is safe period2. You took unwanted 72 after 48 hours and it prevent the pregnancy in around 70-80%.But period can be delayed by 10-12 days as it cause prolongation of second phase of the cycleWait for the period to comeIf period will delay by more then 12 days then go for urine pregnancy test and or blood HCG to confirm the pregnancy.If you will be pregnant then still you can terminate intrauterine pregnancy by abortion pill under the advise of the gynecologistMeanwhileAvoid stress, take healthy diet, drink plenty of water and do regular exerciseHope this may help youContact HCM for further health queryBest regardsDr. Sagar </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Is low LDL level sign of cancer? Patient:I went to the Dr today...I had a CPX a month ago. I went in to talk with the Dr today and found out I have HPV (some abnormal cells) and my LDL is only 38. I am worried due to I am a CMA and my understanding too low of LDL could mean cancer. I have only had one partner for over 20 years and I am 36 years old. [/INST] Doctor:Hi, dearI have gone through your question. I can understand your concern.Low LDL level has no relation with any cancer. It is a type of cholesterol. You have HPV positive. so it increase the risk of cervical cancer. For that you should go for regular screening test. Pap smear examination is the screening test for cervical cancer and you should go for regular screening. No need to worry. Just be relaxed. Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What are the side effects of long term use of eptoin 100 tablets ? Patient:hi doctor i m taking eptoin 100 tablets 3tab daily at bed time.i hav been taken this medicine from last 6years is there any harm to me or my body for having this eptoin 100 long time .6 years back in a night whn i was sleeping i don,nt know wht will happen .but my parents on that time is with me they told me wht happen ,but i didn t know.so in the morning my whole body paining and i hav got slight cut on my toungue.its very painfull.so next day we rush to the doctor than he told me it s a seizure attack but its not to be worrying sitution thn he started eption 100mg for three years, but somehow after 1 year its a single miss of tht dose, docter told me i hav to restart my medicine course from the next day for next three years [/INST] Doctor:Hi, The advice from the doctor is right. You cannot afford to miss a single dose. Coming to long term affects of taking Eptoin, the benefits outweigh the risks. Having said that I suggest to get Serum Eptoin levels once every 6 months. It also needs a follow up in 4 month with the same doctor to check the side effects. Regards. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Will molar tooth removal cause eating difficulties? Patient:Have a small abscess on the first molar on the lower right side of my mouth. Going to dentist tomorrow. The tooth is capped and I think I want to have it pulled due to finances with root canal and crowns. I have no molars behind this tooth. Will I have trouble eating if I decide to pull it? [/INST] Doctor:Thanks for your query. I have gone through your query.Yes first molar plays a major role in chewing because its the key for occlusion.you will have difficulties in chewing if you get the tooth removed. If the tooth has sufficient bone support then try to save it. You can get the RCT done first that clears the infection. Once you get the money you can get the crown placed in later stages.since you dont have any teeth behind first molar, you cannot go for fixed appliance even if you want in future. Try to save the tooth. I hope my answer will help you. Take care </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Does masturbation cause painful urination and blood in urine? Patient:hello, I have not been sexually active for months and I have been recently masturbating at least every day for the past 2 weeks. Today I noticed painful urination and some blood in my urine. Is masturbation related? I am also in another country and the food is different from that in the U.S. [/INST] Doctor:Hello and welcome to health care magic. Pain during urination and Hematuria are signs of urinary tract infections and not due to Masturbation. My advice is to visit a Urologist /Physician and let him test your urine and blood. He will give you antibiotics like Norfloxacin for 5 days and bladder muscle relaxants like flavoxate to reduce the pain. Make sure to drink at least 2 litres of water per day. And this UTI is not food related. Hope this discussion will be helpful to you. Thank you. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: How to treat purple bruise on knee and lower foot after injury? Patient:FELL DOWN LAST TUESDAY IN THE YARD ON RIGHT KNEE. KNEE BRUISED AND PURPLE AT BOTTOM OF KNEE. LEFT SIDE OF FOOT ABOVE HEEL PURPLE NOW AND FRONT OF CALF TURNING PURPLE IN PLACES. ELEVATING IT AND TAKING NAPROXIN AS OFTEN AS POSSIBLE. SWELLS AND ITCHES OCCASIONALLY. WHAT ELSE CAN I DO FOR IT? JUST WAIT FOR IT TO HEAL? [/INST] Doctor:Hi, Firstly take an X-ray. As it is important to look out for any bone Injury which may get unnoticed at times. Also do hot water fermentation and use crepe bandage to support the knee and ankle joint. Keep the leg elevated over a pillow and do ankle toe movements slowly. Wait for the X-ray report and also allow the skin discoloration to come down. Strengthening of the thigh muscles shall be followed once the pain is reduced. 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: What causes chills and rashes all over the body? Patient:I had takin a little bit of meth last night while i was drinking alcohol and earlier this evening i started gettin g rashes under my arms, neck, stomach,head and back. i keep gettin chills all over my body. And also tingles everywhere. what does this mean and what do i do. [/INST] Doctor:Hi, meth...methamphetamine is CNS stimulant drug and likely to get abused by its euphoriant effect so it should not be taken without medical prescription and defiantly not to be taken with alcohol. Your rashes,irritation, all over body could be due to interaction of both of drugs.u consult dermatologist or physician for skin problem and meth..drug use </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes bumps on the side of my penis? Patient:hey i was curious about bumps the showed up on the side of my penisew thiere somewhat in a clump but then there one under my head of my penis and one by the hair area and its not herpes cause there no blisters there the same coler as my skin and cant pop i tried... any ideas? [/INST] Doctor:Hi, The cause of such bumps depends on your age, pain and sexual activity. At age more than 40, associated with pain and bending, it may be Peyronie's disease. In younger age, it may be because of injury or simply skin boils or pimple. It's difficult to comment without examining it. Please get it checked by the doctor. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Sujoy Dasgupta, OB & GYN Specialist </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: How do i get rid of gall stones? Patient:Hii I m 29 yrs.... I m having gallstones of 22mm.... but yet I dint felt any symptoms other than indigestion ( not always, sometimes) I am taking ayurvedic treatment... the stone is too big.... vl it b cured.... should I go for surgery or stick to ayurvedic medicine...I want to plan my pregnancy now [/INST] Doctor:Hi, I understand your concern.I see similar problems many times in my clinic. And I always try to get more dipper with examination, particularly if patient planing a pregnancy.Gallstone disease during pregnancy may escalate attacks of colic and can lead to surgical treatment during pregnancy, that's why such question have to be discussed together with your gynecologist.Usually I recommend to make a laparoscopic cholecystectomy, then follow a special diet during whole pregnancy.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. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest treatment for gettting pregnant? Patient:hello madam i am married from last 3 year but not conceived...i am on treatment by Dr. NUTUN JAIN...MUZAFFARNAGAR....from last 2 years...she did lap also but no result...3 times IUI....this month she gave me dexsona + siphene...plz tell me the problem [/INST] Doctor:then I m suggested plz try for Ayurveda treatment..in ayurveda there is uttar basti treatment vary helpful to conceive </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest treatment for persistent vomiting Patient:Two year old vomiting for about two weeks, no fever, started out only vomiting during the night after she would go to bed and now in the evenings. Doctor prescribed and anti-biotic. She stopped throwing up for about two days and now it is back and worse than ever. Doctor ran a CBC and ordered a stomach x-ray it they were normal. Anyone have an idea on what this could be? [/INST] Doctor:Hi, tahnk you for posting your query here. Forom what you ve described, it seems like your child has GERD (reflux). they tend to vomit when going to bed or after a heavy meal.My advice would be to give smaller meals, a little more frequently, avoid chocolate/tea/coffee which increase reflux. To make her walk around a bit after her meals, not immediately lie down. keep her bed reclining at a 30 degree angle (you could put some blocks under her head-end side of the bed).Ask your doctor about starting domperidone which helps reflux. ondansetron half hour before food will help the vomiting.Hope this helps you, take care.Regards,Dr. Vaishnavi </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What is the lump on my anal opening that usually bleeds? Patient:I have a quarter sized lump on my anal opening that bleeds fresh blood mostly all the time it is kind of tender and does not itch or anything like i have had it for a couple years too embarrassed to tell my doctor there are times i wake up with dried blood in my boxers quanity quite a bit for what this is what is it? [/INST] Doctor:Hi ! Good evening. I am Dr Shareef answering your query.The lump on your anal opening could be a prolapsed hemorrhoid which would be bleeding on friction with clothes. The tenderness could be due to super added infection on it.When you visit your doctor, you should have complete faith in him and tell him all the details of your problem without any hesitation. This way you would be better examined by your doctor, and would derive maximum benefit from his services apart from getting yourself treated well. You have to get it examined by your doctor /surgeon for a definitive diagnosis and treatment.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. Wishing you an early recovery. Dr Shareef. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest treatment for lump under eyelashes Patient:My child has a hard lump under the bottom eyelashes but not near the rim of the botton eyelid. It is red in color and has been there since right before Thanksgiving. They have given him oral antibiotics and now an ointment but it is for the inside of the eye and they are having me put it on the lump. Nothing is happening. What should I do? Child is 5 yrs, 39.4 lbs., no major illnesses [/INST] Doctor:Hi, Thanks for query to My HCM virtual Clinic.I studied all details of your query.I understood your health concerns about treatment of lump on Eyelids-Treatment-As the treatment given from your doctor is not reducing the eye lump,it is natural to be worried for your sons eye lump.Your son seems to have Chalazion / or Meibobian Cyst-which is the cystic swelling of the eyelid blocked oil glands.Hot Compresses,Anti-inflammatory oral Syrup,would take care of it as such lumps reduce on its own in 2-3 mths time with this treatment.IF no reduction please consult Opthalmic / Eye Surgeon who would treat it accordingly after verifying local conditions of eyelid lump.Hope this reply would help you in resolving this complex query and anxiety with it.I would appreciate if you hit thanks and write excellent review comments to help needy visiting patients at HCM.Welcome for any further query in this regards.Good Day!!Dr.Savaskar M.N.M.S.Genl- CVTS.Senior Surgical Specialist. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest medication for fever Patient:Hi, may I answer your health queries right now ? Hi. My husband has MS and now he got flu. He has infection in throat and serious fever. Fever make him unable to move, so we have problem even with going to bathroom. I need to do some thing for his fever as soon as possible [/INST] Doctor:To reduce the temp now you can give him CROCIN tablet immediately which will reduce temp and make him feel little better and also cold sponging will help if temp is more than 100F. Regarding his throat infection he may need to take antibiotic like AZITHROMYCIN daily for 3days .but to suggest dose we need to know his age,weight and all his current medication and also we need to do physical examination of throat.after giving crocin once he feels little better and goes to loo it is better you take him to a family physician and get him treated.food given to him should be hot and also try to ensure warm drinking water till throat becomes normal. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: How many pills of clomids should be taken for infertility? Patient:Hi how u doing? just want to know i been trying so hard to have a baby for the pass 2 to 3 years and it didnt work for me. I have place in a order for clomids it takes 10 to 25 business days to reach. I just want to know how many pills do i take each day? [/INST] Doctor:Clomid contains clomiphene. Is used to stimulate the follicles of ovaries.So follicles increase in the size and get mature for ovulation and they help in fertilization.Idly this drug should be started on 3rd day and continue for 5 days. It can be given as 50 mg od to 100 mg od. If 50 mg doesnt work then dr can increase the dose.So it is better to consult a gynecologist after his/her advise take this medicines. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest remedy to reduce swelling under jaw and vocal chord Patient:i have a swelling under my jaw and between the jaw and vochal card without pain....can u suggest the treatment and tests and reasons .....i am experincing this problem since 15 days...before this i have not any problems like this...i am 20 years old and 5.5 inches and 54 kgs.i already concerned a doctor ...they gave a treatment for a period of 10 days ....but no improvement....hence they offered me some tests like ultra sound scanning and some tests for neck [/INST] Doctor:Hello, Thanks for consulting HCM, Read your query, as you have swelling under jaw and vocal cord region this can be due to some factors like carious , decayed or any root stump present In oral cavity ,inflammation or obstrustion of submandibular gland , phayrngitis or laryngitis condition . I will suggest you to consult an oral surgeon for examination of oral cavity and swelling of jaw and neck region , if cause is of swelling is not ruled out then consult ENT Specialist for examination of neck.Hope it will help you. Wishing you good health.Regards , Dr. Priyanka tiwari </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: How can allergic rhinitis be treated? Patient:Morning, I have had what appears to be an allergy reaction to pollen since moving from One city to another. Runny eyes, runny nose, very bad chest cough, hot and cold flushes, slight temperature elevation. Saw my GP who said it was a reaction to pollen due to area I live in. Gave me Telfast 180mg. I have had this for more than 3months. Very tired, lack of sleep at night due to coughing fits etc. Also take a Multi Vitamin as well. I m 56 yrs and not getting any younger. Starting affect my daily routines, work, and external activities. Any suggestions please. Tony [/INST] Doctor:Allergic rhinitis is not a rare disease and can effect a people of differernt ages. All the symptoms that you are having are more or less classical for this condition. There are three major ways to go about in treating Allergic Rhinitis1. Prevention - Taking medications to avoid having the symptoms2. Symptomatic - Taking medication to alleviate the symptoms you are experiencing.3. Immunotherapy - Make you immune to the allergens causing the symptoms in the first place.In your case as your symptoms have already started. We need to get your symptoms in control first. You are unfortunately having the full package of symptoms i.e., your eyes, your nose and your chest, all three things are involved. If your symptoms have failed to settle with an anti allergic medication like telfast and are experiencing fatigue and lack of sleep then its better you see your physician sooner than later. I would suggest that you should be on the following drugs initially and then the drugs can be slowly tapered off.1. Steroid nasal spray2. Anti allergic eye drops3. Anti Allergic oral medication4. A Steroid + Beta Agonist inhaler (If the chest on examination reveals narrowing of airways)5. In extreme types of allergic Rhinitis your physician can even give you a few days of oral steroids to get your symptoms under control quickly.Once your symptoms are under control then he can concentrate on referring you to an allergy specialist for immunotherapy which can take weeks to months to get the adequate relief required. Till then your drugs will help keep your symptoms at bay and help you go about your daily work with little or no problems. I 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 a red open sore on gum in a child Patient:Hi, may I answer your health queries right now ? Please type your query here...My baby is 6 months old and cutting through her third tooth (first on the top gum) She has been upset all day and I've just noticed on her top gum, beside the new tooth, is an red open sore. It's as though a tooth should be coming through but there isn't one there, it just looks red and sore. When her other teeth came through they didn't look like that. [/INST] Doctor:Hi.Welcome to HEALTHCARE MAGIC..I have gone through your query and can understand your concerns.....As per your complain it seems that the open sore area over the gum behind the newly erupted milk tooth can be most probably due to the other tooth that might be going to erupt in the due course of time and the gum might be tearing to let the tooth erupt..Do not worry, you can apply a numbing gel over the sore but be precise to apply a very small quantity that too only on the sore but only after clinically getting her evaluated by a Paediatric dentist..You can also do cool compresses over it..Feed with cool milk..Hope this information helps..Thanks and regards..Dr.Honey Nandwani Arora.. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest remedy for fluid at the feet Patient:Dear Dr. Agarwal, Last Sunday I had been fallen from the bike and there created a wound beneth my knee. The location has been swalloed with a reddish spot but not bleeding. That day I took a titenus injection and consulted with MBBS doctor, who suggested me for a 5 day Amoxicilin and Potassium Clauvanate Course alongwith Pain Killer and Betadine ointment. After using it for 5 days I found little improvement but nor remarkable one though doctor assured me it will be OK within 5 days. After that I consulted with another doctor who told that Amoxicilin is not perfect for this condition and suggested Cefuroxime Axetil Dispersible Tablets for 4 days with 2 tablet daily alongwith Chymoral Forte and ointment Mupirocin. After using this I found the would becoming dry but there fluid has started to gater at my feet resulting into problem in walking. Kindly advise what to do?? I am 45+ with no suger having medication of BP and is working in Office. Pl. note that I have attend Office due to some urgent work . Kindly advise suitably per return. awaiting for your reply [/INST] Doctor:Hello, If I were a treating doctor,I would consider possibility of cellulitis only after clinical examination.Visit General surgeon who might apply Magnesium Sulphate Dressing along with change in antibiotics. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Rajesh Gayakwad </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest home remedy for limpoma Patient:I have a very large growth on one side of my rib cage and a smaller one on the opposite side. One doctor believes that it is a lipoma and another doctor thinks that the muscles split after delivering three close to nine pound babies. I was rushed to the hospital in the Fall of 2010 for severe pain under my right rib cage . Nothing was concluded from all the cat scans and utra-sounds that they took. I was sent home with Vicadin and still in pain. The second doctor that I previously spoke about said that the emergency room doctors would have noticed cancerous tumor at that time if there was one . I did go to physical therapy to try to pull the muscle back together. No noticable changes were found. The therapist said that surgery would be the only way to correct this. If, however, this is a limpoma,what type of home remedy would you recommend? I am so confused. Should i disregard this as being something serious or should i try to handle this on my own? [/INST] Doctor:Hello, I have a certain question regarding the swelling. Has it increased its size? is there any similar swelling? And as you have said nothing was concluded from CT and USG. A big probability is it might be a LIPOMA itself. Which is a benign swelling and can be removed with a simple surgery. TO CONCLUDE: 1) Get to a surgeon and consult 2) If it's a LIPOMA can be removed by simple surgery. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr ASIF, General & Family Physician </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: How to get rid off the lump after got hurt above the left eye? Patient:I fell down three steps to the garage on Feb 20th,and fell on my face, hitting the left side of my forehead, just above my left eye, on the hard cement floor. I was not able to save my face with my hands as I was carrying a basket .I went to a hospital emergency dept., and was given a C.T. scan. There was no bleeding or other problems internally. The lump was as large as a ducks egg...and now it is about the size of a pigeon s egg. there are still black marks under my left eye , as the veins continue to clear out the blood. How can I help this process to speed up ? [/INST] Doctor:Hi ! Good morning. I am Dr Shareef answering your query.With your history this seems to be a resolving hematoma in the subcutaneous tissues of the area. As the hematoma was large enough initially, it might take more time for the blood to get absorbed gradually. You can apply a pressure bandage over it if need be. However, it would take its own time unless it has got organised. In that case it might have to be evacuated by a small incision under local anaesthesia. You have to take the opinion of a general surgeon in that case. I hope this information would help you in discussing with your family physician/treating doctor in planning your treatment. Thanks for using the health care magic forum for your query on health. Wishing you an early recovery. Dr Shareef. </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 cervical spine problem? Patient:hi Dr.I am Srinivas from vijayawada India I am suffering with swelling in my left hand little finger. my x-ray report shows that problem in cervical spine c4-c5 & c5-c6. here dr. told me that due to that problem you are getting pain &swelling ji left had fingers, he advised to wear cervical collar. is it sufficent . pl advise me how to over come the problem. [/INST] Doctor:Hi there, welcome to HCM, thanks for your question.It is highly unlikely that the sweeding in your left little finger is caused form your cervical spine.Cervical spine compression would cause pain or numbness or burning sensation or weakness in your fingers.But never compression in cervical spine has not been associated with swelling in fingers. I would suggest you to be seen and be examined by an orthopaedic surgeon or hand surgeon to get yourselves evaluated for other cases of finger swelling.Hope this answers your question.All the best.Thank you.with best regards. Dr.SBK </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes thick brown discharge during pregnancy? Patient:My wife is 24 weeks pregnant. Today she got thick bown discharge. Her OS is also opened, dilates 2cms. the opening detected at 20 weeks. now she is advised strict bed rest and proluton 250 mg is being injected weekly. The activity of child in the womb is normal. now we are worried about the thick brown discharge. Pls comment Bkn [/INST] Doctor:discharge is common in pregnancy but brown means she had slight bleeding . still for confirmation get her check by gynaecologist . </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Q. For how long should I take Kalachikai powder to overcome PCOD problem? Patient:Hello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem? [/INST] Doctor:Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult 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: What is the cause of tightness across the upper abdomen? Patient:Hi, yes I would like to know what could be causing a tightness across the upper abdoman. It is present all the time and I have been having this for the last 4 years. Sometimes I have to stand up if I am sitting or have to go lay down because it is so uncomfortable. Also I don t know if this is associated with it but every morning I wake up or even just wake up from a nap I have a really bad headache across the back of my head with pain in my neck that runs down into my upper back. Thank you [/INST] Doctor:HI. As this is there for 4 years means you must have shown to many Doctors and must have taken medicines too . Go for MRI of the spine you will get the problem responsible for both the problems you have. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest treatment for knee pain other than knee replacement Patient:I need a knee replacement but I m very scared. was told my legs are to big with fat and could get bold clots and die. I have bone on bone and wearing a hole in bottom bone. Lots of arthristis (sp wrong).. Don t know what to do? Have no life. Can t hunt with my husband. [/INST] Doctor:I understand getting any operation done is scary , there are some details which are missing to guide you properly , your age , your weight ,exact xray report , how much compression is there??? have you tried conservative treatment before and for how long? If you are really not in favour of going for knee replacement , these are the things you should work on 1.reduce your weight (knee joint is a weight bearing joint , even 2 kgs reduction will make a difference )2.hot fomentation3. strengthening exercises for knee as guided by physiotherapist.4.calcium rich diet5. continue walking if all this helps you by 50% at-least continue with it otherwise knee replacements are good answer to improve your quality of life. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suffering with cervical and thoracic disc herniation, neural foramina stenosis, shoulder blade osteophyte formation with a ridge, have arm weakness and numbness with neck pain, advised cervical discectomy. Suggestion? Patient:Im43YEARS young and have been diagnosed with cervical and thoraic disc herniatios and neural foramina stnenosis also i ond left shoulder blade osteophyte formation with a ridge. I get left arm weakness ,NUMBNESS and severe pain in neck down my arm. I received 8 epidurals between the neck and thoraic spine with temporary relieve.Im in physical therapy which only provides relief right after they do it. my doc want to do a cervical discetomy is that now the best way to go [/INST] Doctor:Dear friend , if conservative measures are not helping, modern spinal microdiscectomies come to help. If an expert is advising surgery, then in good surgical hands, at good high turnover centres, discectomies could help, esp. if you have distressing neuro signs. I am not a spine surgeon. but looking at the results of surgeries at our centre, I think they should help you. I would advise you to go by your specialist's suggestion. thanks for being at HCM and hope to keep posted on your progress. good luck. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest treatment for excessive breasts in a child Patient:My 12 year old granddaughter has developed excessive breasts. Ultrasound showing multiple large solid tumors. She has biopsies scheduled for next week in Michigan. Can you tell me what the incidence of this being carcinoma. Adult females have fibrocystic disease and fibroadenomas, but I ve never hear of a twelve year old. We are very worried. [/INST] Doctor:Hi...even adolescent girls can have fibrocystic disease and fibroadenomas. this is occurring due to hormonal changes due to epidemiological shifts. The biopsy results will be conclusive. Do not worry. Nothing will be untreatable in todays science.Regards - Dr. Sumanth </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Had miscarriage. Have PCOS. Cannot ovulate. Can ovarian drilling help me to get pregnant? Patient:Hallow Doctor, I am Mrs S. Banerjee, Age 30 wight 55 kg Height 5 ft, Hormon report = all are well , My ovary are affected with PCOS, I use metformin for last 3 year, and use letrozole 2.5 , After that i got pregnant , But unfortunetly i have a MC on feb 2011, After that i cannot ovulate , My endometrial echo is thick 15 mm , Should i go through ovarian drilling and is it safe and can i get pregnant after that? [/INST] Doctor:Hi, sorry about the MC. Irregular menstural cycles & inability to conceive are the common problems for women with PCOS. Improper ovulation & excess amount of androgen are the main reasons. Ovarian drilling (ovarian diathermy) is done in women with PCOS to improve the fertility rate. Destroying part of the ovarian tissue restores regular ovulatory cycles in around 80% of women. It is a surgical procedure that triggers ovulation. It is an option only when other measures like weight reduction & fertility drugs fail. It is a safe procedure in expert hands. The aim of this laproscopy procedure is to destroy testosterone producing tissue in the ovary. A combination of Letrazole & Clomiphene Citrate has been found to be useful in improving ovulation. Your BMI is in normal range but the endometrial thickness is high (normal 6.7mm). Since Letrazole has not helped you, you can undergo ovarian drilling. Good Luck. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest remedy for lumps on thigh with bruises Patient:I just fell today while hiking onto a log. I have a large lump on my thigh just above my knee. Few hours later it is now turning into a bruise. Just a little pain. I am far from my home and my doctor., I have taken advil. Any advice until I get home would be greatly appreciated. Thank you [/INST] Doctor:Hi,It seems that there might be having formation of hematoma following fall producing large lump.As there is not much pain, nothing to worry for having any injury in knee or fracture.Apply ice pack 2-3 times a days for 2-3 days.Swelling will subside gradually.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 causes a temporary paralysis after a break up? Patient:When my boyfriend broke up with me, he was crying and very emotional. This was very strange because he is not an emotional person at all. He couldn’t move; it was almost like he was paralyzed. Fortunately after a few minutes he could move again. It was really scary and obviously sad because he was breaking up with me. Could you explain the temporary paralysis? I just don’t understand how that happened, and he was not exaggerating. [/INST] Doctor:Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. Due to underlying stress people can have conversion or dissociate reaction. It could have been one of such conversion episode. They tend to remit after a few weeks or months. People do it unconsciously. There are medicine and psychotherapy available to tackle such episodes. 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: Does masturbation and varicocele affect fertility in men? Patient:hi am 21 years old, i used to masturbate frequently until i started to feel weird feeling around my right Or both testicle, whenever a foreplay occurs or anything arousing for a while, my vas deferens (or anything near it) swells and becomes quite painfull and causes discomfort (the left more than the right) is this related to the varicocele? does both affect fertility? should i be worried? [/INST] Doctor:Dear, We understand your concernsI went through your details. Masturbation do not affect your fertility. But vericocele does affect fertility. You need to consult an urologist to confirm your problem and get treatment for the root cause.If you require more of my help in this aspect, please use this URL. Make sure that you include every minute detail possible. Hope this answers your query. Further clarifications are welcome.Good luck. Take care. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Taking birth control, having on and off bleeding. Doctor suggested to take one pill during night and morning Patient:Hello Dr. Mia Lundi my name is Latisha shivers and I am 34 years of age and I been going thought some female issues. I been on birth control since high school and until now and I been having on and off bleeding and I also been through several different types of birth control and it seems like the same constant bleeding keeps on recurring. Now as we speak I went to another doctor for an second opinion today and she told me to take one pill in the morning, and one pill at night. Now Dr. Lundi I don't feel comfortable with that but for and three opinion am I suppose to do that because I really want to which to the patch.I [/INST] Doctor:Hello LatishaThanks for writing to us for your health concern.You might be experiencing on and off breakthrough bleeding due to low dose of birth control hormones.In this scenario, doctors often prescribe preparations with higher hormonal content.Hence, the advice to take two pills a day.I understand your reluctance to do so.The generic patch too might give you trouble, as it has equivalent hormonal content ( similar to the pills ).Why dont you give the IUD a try , or maybe Implanon ?That might serve your purpose better.All the best.Take care. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Q. Is it advisable to sleep with gauze in mouth after tooth extraction? Patient:Hello doctor, I got my number 32 extracted at 1:30 PM. It is now 12:40 AM. I am not bleeding a lot but it is still coming out. Any advice? I would like to sleep but would hate to swallow blood in my sleep thus making me sick. Can I sleep with gauze in mouth? [/INST] Doctor:Hi. I have gone through your question. I can understand your concern. If the bleeding is still there and you are not able to sleep, change the guaze and wet the another guaze and put it there. If bleeding will not stop you can use a guaze with ice pack. My suggestion is do not be apprehensive, as raised blood pressure is also the cause for bleeding. You can also visit an emergency room for further treatment. The two reasons may be the left root stem and high blood pressure provided you do not have any underlying blood disorder. Yes do not sleep with guaze as it may obstruct your airway and can be fatal too. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Can pregnancy happen after taking Nordette pills? Patient:Hi, me and my gf had sex yesterday and finished around 1pm. Accidentally when I pulled out, the condom was stuck inside her vagina as in literally inside. After 10seconds of realizing it was stuck inside I pulled it off, I am not really that sure if there was a leakage or if I ejaculated in the condom or inside her. At 2:28pm the same day she took Nordette (4pills at once) and at the next day 2:28am (after 12hrs) she took another 4 pills. Is nordette really effective? What are her chances getting pregnant? Thank you [/INST] Doctor:Hello dearI understand your concernDo not worryChance of pregnancy is less.Nordette sed in correct dose and it is highly effective in preventing pregnancy.It isupto 80% effective in preventing pregnancy.It may cause delayed in petiod by1-2 weeks.If nex period will delay by more than 2 weeks then consult gynecologist.Avoid stress, take healthy diey, drink plenty of fluid and do regular exerciseBest regardsDr. Sagar </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Why are my testicles of different size? Patient:hi, My testicles are different in size since 5 years now. the left one is bigger and sometimes I feel some slight itch like feeling on it. I used to wear loose underpants since teenage time, but from last year I am wearing some skin tight underwears. I am unsure if the left testicle has some uneven upper portion which in my case is present, but I am worried that this is not a healthy sign. [/INST] Doctor:HelloThanks for query .You have doubt about the size of your left is bigger than Rt testicle.I would like to state that the size of the both the testicles is never same in every individual .One is always bigger than its counterpart .More over it has no significance as far as function of the testicle is concerned unless there is vast difference in size of the testicles (One testicle is atrophied due to some pathology)/Consult qualified General Surgeon or Urologist for clinical examination and get Ultrasound Scanning of Scrotum .This will help to allay your anxiety .Dr.Patil. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Feeling sick after eating. On birth control. Irregular periods, stomach pain. Negative pregnancy test. Chance of pregnancy? Patient:i get sick to my stomach after eating at times and just out of the blue. And i have been eating a lot more than usual, i am on the birth control shot and my cycle is not normal so i spot a lot. I get sharp pains through my stomach once in a while, and in my privates after intercorse but i took a pregnancy test and it was negative. Is there a chance i could be pregnant? [/INST] Doctor:hi,thank you for your query,the fact that you are experiencing irregular periods and spotting and also cramping is a sign of the side effects of the birth control.it means that your birth control method is not suited for you.these are not the signs of pregnancy.but still if you want to be sure,you can undergo a blood test.i would advise you to consult an OB/GYN to change your birth control method.thank you,wishing you good health </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What medication is suggested for mass on both adrenal glands & white cells in urine? Patient:I recently had a CT Scan and prior blood work. My doc. informed me I have a mass on both of my adrenal glands and I also had white cells in my urine. What could the mass's be and could they be related to the white cells in my urine as a sign of something? [/INST] Doctor:HelloYour CT findings suggests bilateral adrenal mass.Adrenal mass may be due to many causes like benign or malignant causes.You may need hormonal assay and CT guided biopsy.Commonly adrenal mass is due to adenoma,this is a benign cause.WBC in urine may indicate urinary tract infection.You may need clinical correlation and investigations like routine hemogram,random blood sugar,Urine culture and sensitivity(C/S).You may need antibiotics depending upon C/S report.You should drink plenty of water.Get well soon.Take CareDr.Indu Bhushan </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes relapse of jaundice? Patient:Hi..I took a bilirubin test 3 months back..It was around 4.8 and i took medication for a month and it came down to 0.3...Again, last week, took a bilirubin test and it increased to 4.5....I don t reason for relapse jaundice...Checked for hepatitis b and it s negative as well..What could be the reason for relapse jaundice and how should I ensure that this will not come again... I, m currently under medication. [/INST] Doctor:jaundice is not always due to hepatitis sometimes obstructions in bile flow can also cause jaundice take an abdominal CT to confirm about billiary obstructions if that is not the case there is a high chance your will recover completely and probably it will never repeat after 2nd instance it is very rare </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Hard lump in the gum after molar extraction. Abscess? Need medication? Patient:hi i had a right rear molar extracted about 3 years ago and in its location a hard lump or protrusion has appeared in the last week that is painful. Can this be a piece of bone the was left over from the extraction or a abscess .? Should i take any over the counter meds until I can afford to go to the dentist in about 2 weeks. Also what would be the most likely treatment for either? [/INST] Doctor:Dear friend.Thanks for sharing your concern.The hard lump that you are experiencing over the extraction site could be definitely a bone piece or an out growth called exostosis.It is better to get it clinically examined to avoid any cyst or tumor developing there.you can take pain killer for the time being but please see your dentist soon.Also do warm saline rinses every day until you see your dentist and maintain very good oral hygiene.Hope it helps.Thanks.Take care. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What is normal range in blood reports? Patient:I HAVE LUPUS, AND JUST HAD BLOOD WORK DONE. MY DR SAID EVERYTHING WAS OK. I TOOK A COPY OF THE BLOOD WORK HOME. AFTER I READ THE REPORT, I DON'T THINK EVERYTHING IS OKAY. MY WHITE CELL COUNT WAS HIGH (12.9, MY PLATELET COUNT HIGH (18.1) ABSOLUTE NEUTROPHILS HIGH (10243), BUN/CRBATININE RATIO HIGH (31), UREA NITROGEN (BUN) HIGH (39), CREATINE RATIO HIGH (31) BESIDES WHAT WAS LOW. DOES THIS SEEM NORMAL TO YOU, PLEASE HELP [/INST] Doctor:Hi,Thank you for your query. I can understand your concerns.i think you are having Lupus nephritis. There is also possibility of urinary tract infection,which is not uncommon in SLE, as your white cell count is high with high absolute neutrophil count. High platelet count can be explained by acute phase reaction. i will like to know your Blood pressure also.you will require the following investigationsroutine urine analysis (particularly for proteinuria (may be in nephrotic range), hematuria, RBC casts)24 hours urinary protein estimationurine culture and sensitivity testsyou can undergo these tests and visit your doctor or consult your doctor for advice at the earliest.Regards Dr. T.K. Biswas M.D.Mumbai </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Is it safe to take Paxil during pregnancy Patient:Hey my name is Amber Mamerow, I am 19 years old and I am having a really difficult time. I guess the only way that i can really explain how i feel is to start at the very beginning so i hope you all have time. I have no one else to ask and no one else is taking me seriously. So i decided that i would try one more time to talk to someone. Since around the age of 13 i was on paxil, it helped A LOT with anxiety, i never found a need to get off of it until i accidentally found myself pregnant at age 18. When i was at the OBGYN the nurse told me that i could not be on paxil while i was pregnant and that i needed to try Zoloft. I never saw the Dr, i never talked to them or anything, i just discontinued my paxil and i began zoloft. The first few days i didn’t feel too bad, i didn’t feel quite right, but i didn’t feel terrible. Than for the next month almost (give or take) after that i had every bad side effect that i could have imagined. I read the side effects for the zoloft and i had 90% of what was listed. I told the Drs several times that i didn’t feel good and that i didn’t want to try any other pill i just wanted to stop taking all of them. After i stopped taking everything all together i felt like i was having withdrawal. I have not felt good since. I am no longer pregnant... i did have an abortion.. but that is a touchy subject.. but i figured that’s also involved with health so i needed to not leave out any details. It has been about 8 months since i have stopped all together and i still to this day do not feel good, every single day i have this odd headache. It feels like pressure in my head. I still have some of the issues that i developed while taking zoloft, which i was told would go away once i stopped and 8 months later i am still dealing with, such as my ears ringing, constantly. I never had that problem before this. I have had countless problems since zoloft and i have been trying to feel better without resulting back to paxil, i like being able to know that i can live without it, i no longer have panic attacks, and if i do on a rare occasion i can control it. I feel i have no need to go back on to paxil, but my dr pretty much insists that i go back on it because he is convinced the way that i feel now is all because of that. The way that i feel right now is a pressure in my head, mainly in my forehead and in the back of my head. If i press on certain parts of my head its sore as if its a soft spot. I have a chronic sinus infection that i have had to treat on and off the allergy seasons with antibiotics, which make that clear up, and strangely enough make my head feel completely better. Many of the Dr s thought that it was the sinus infections that was making my head feel weird. But i asked them why than would i feel pressure in the back of my head when i have no sinus s there? So that blew that theory out. I have also had bacterial and yeast infections every once in a while that also had to be treated with antibiotics, and again, (no sinus infection issues at the time) my head would feel better. Another example of this was when i had another bacterial or yeast infection of some kind and while i was taking my antibiotic it began to make my head feel better, but before i was done taking them it started to feel weird again... So talking with my nose dr he decided that it would be a bad idea to take anymore antibiotics because he thought that they were treating SOMETHING in my head, but no one knew for sure what that SOMETHING was. But he said that if we kept miss treating it with antibiotics than it would soon become immune to them. So since then i have refused to take another antibiotic because i do not want to make anything any worse, but the problem is we have made ZERO progress on what is actually wrong, i have spent over 500 dollars trying to find out what exactly is wrong and we have gotten no where. I began to get worried and i asked for an MRI, and a CT scan, apparently they both came back normal, but i had no one read them to me or go over what exactly there was... but they did assure me that i had no tumor or anything. So that helped reassure me for the time being. I have had multiple blood tests for many different things and they assure me that i have no infections or anything, (which confuses me, because if i have a chronic sinus infection.. shouldn’t that show up?..) but either way they assure me that there is no infection. So i am feeling like i am on my own. I have done research trying to find something, anything that could give the same kind of symptoms of what i am feeling, and i stumbled across meningitis. Now i understand that meningitis is usually severe and can do damage in as little as one day... but i have also found and i will quote it exactly as i found it Occasionally, if someone has been on antibiotics for another infection, the symptoms can take longer to develop or may be less intense my source is from WEBMD. Meningitis can also be caused by the spread of an infection occurring near the brain, such as from the ears or the sinuses. It is also an occasional complication of brain, head, or neck surgery. which i was thinking could have something to do with my sinus infection ( which i now have AGAIN, but cant treat because i cant take antibiotics until we find out what is wrong with my head and why it feels better with antibiotics). I have tried talking to 3 different doctors. My primary, My ear nose and throat doctor, and they both ended up sending me to another doctor... which i cant quite remember who or what he is suppose to do.. but all i remember is him being extremely rude and ignored anything and everything that i had to say.. so i got absolutely no where with him. I left his office in tears and had to pay 80 or more dollars just to be in the same exact spot I’ve been in for months. I have had blood work done and many other things done, i asked my primary doctor out of desperation and last measures to see if i could get a spinal tap to make absolutely sure that it was not meningitis. I am exhausting every option, i am running out of money and i am desperately searching for an answer. I am 19 years old and i have no idea what is wrong with me, it is effecting my everyday life and i have spent so much time, energy and money into figuring out the possible cause of what is going on. I feel like no one is taking me seriously now because my primary doctor has just suggested that i try taking my paxil again. Its very frustrating because i feel like no one takes me seriously once they learn that i have anxiety and they assume that it is all in my head or just taking a simple pill with help make everything better. It just seems like whatever it is, is getting worse, and i would really appreciate help from anyone that is willing to help. I have not taken antibiotics in many months and i feel like my head just keeps getting worse. I don’t know how to explain it... i have been told that it could be cluster headaches... but i have had headaches, i have had migraines.. they are nothing like this. It is a constant, all day everyday, from the second that i wake up to the minute before i fall asleep the same feeling. Lately i have felt extremely tired, my eyes have started to hurt.. i had to go to the eye dr because my vision has been doing weird things, but they said that i have perfect vision and the only problem i have is i have hard corneas.. or whatever that is that causes you to have higher pressure in your eyes without having glaucoma. I have been noticing trails, i see halos around objects mostly people, i see something that i would consider visual static.. and this has all started just recently.. about maybe a month its been happening and getting worse. At first i could see visual static and maybe every once in a while i would see trails, than i started to see halos. I try to ignore it, because i don’t have enough money to go in for a check up any more, i don’t know whets wrong so i don’t know how to have anyone fix it. The reason that i decided to write to you today and not try to ignore it like i do every other day is because i was in the shower today and out of no where i felt like i was going to pass out, i felt this weird sensation that the room was just getting dark and i was just going to pass out, so i jumped out of the shower and sat on the floor for a minute. I had this stabbing pain in my back and my stomach and i felt like i was going to puke, when i felt as if i could stand i did so, and i left the room to get some fresh air, immediately i felt as if i was going to puke again and i ran into the bathroom and i had one dry heave... and felt completely normal again. That is the first time anything like that has ever happened to me before. So please, i am completely lost on what to do. All i want to know is how do i find out what could be wrong with how my head feels. What could be causing it, why does it feel better with antibiotics and what can i do. Please if you have any words of advice please let me know. I am sorry for such a long note but i am running out of people to talk to. Please and thank you. Amber Mamerow [/INST] Doctor:Hello Amber. I completely understand how it feels not to be taken seriously. While I was going through your answer, diagnoses like chronic sinusitis, cerebral venous sinus thrombosis and also vascular headaches did occur to me, but they are difficult to prove with a normal MRI or CT (not vascular headaches though, they appear normal on imaging). The paxil you were taking earlier is not only an anti-anxiety drug but also is used in certain intractable pains, hence I feel your doctor had asked you to restart it hoping for some positive results. However, since you are firm that you donot want to restart it, and I appreciate the decision of trying to manage without the anxiety pills, I feel we have to move on to other possibilities - Benign Intracranial Hypertension is one of them. I would suggest you to get Vitamin A levels too. A spinal tap would certainly help in this case to reach a diagnosis. Hope this helps.Regards,Dr Geeta </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What medication can I take to reduce pain after a back surgery ? Patient:Hi had back surgery four weeks ago tomorrow s1 decompression still had pain after the surgery in left buttock and left leg and numbness in left foot had nerve block injection one week after surgery no relief still taking a lot of pain relief mainly endone also went back to Nero last week and I am now on neurtin but no relief as yet please help Hi had back surgery four weeks ago tomorrow s1 decompression still had pain after the surgery in left buttock and left leg and numbness in left foot had nerve block injection one week after surgery no relief still taking a lot of pain relief mainly endone also went back to Nero last week and I am now on neurtin but no relief as yet please help [/INST] Doctor:hi welcome, first itself i say surgery for disc compression is not the remedy since the disc is not an over growth or any unwanted item of body we should protect that one with the treatments. i am an ayurvedic doctor who done all research work in lowerback pain (sciatica) for the last 7 years both in MD and PhD , i can say we can treat this without surgery, any way you did that so we can make you only some more better way without pain killers you will not feel pain. that much i can do for you since surgery over. write to us in detail we can discuss about you christyjoseph1@gmail.com 09895313720 thanking you </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes pain above the waist? Patient:Hi, I am Raj. My uncle age 50 got pain above the waist (back side-left). We have done X-Ray but did not get any factute or any thing . So doctor adviced some medichine but its not helpfull. What might be the problem ? which specialist doctor should we consult ? Thank U ! [/INST] Doctor:you need to get an NCV don't for the upper limbs. it could be a spasm of the flexor or extensor retinaculum. apparently you may undergo an MRI to check if any possible tissue damage is there. visiting and orthopedic specialist or a physical therapist will be of help. sometimes exercise helps advised by a physical therapist. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes needle like pricking around the nipples? Patient:I am a 61 year male on good health, although a week ago I suffered a laceration on my right thumb. I had a tetanus shot two years ago. Problem: In the last two days I feel a needle like pricking around my nipples I notice them in the afternoon or evening like once every hour when I am standing [/INST] Doctor:Good day and thank you for being with healthcare magic! You may be suffering from Herpes Zoster. This is a reactivated chicken pox virus and is not an STD. This is felt as pain in the chest area dermatomal in location. Other conditions would be mastitis (inflammation of the mammary gland) - rare in men, and chest pain that is cardiac in origin. I would ask you to see a doctor to be safe. I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications at: I would gladly help you. Best wishes. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Q. I have vision loss in right eye, and scissoring reflex on retinopathy. Please interpret my MRA findings. Patient:Hello doctor, I am looking for a detailed read and interpretation of the MRA. Please be as detailed as possible with any abnormal findings you may see. My symptoms are progressive vision loss in the right eye, temporal headaches, and tenderness on the right side, headache on back of the head (right side), scissoring reflex via retinoscopy. I have attached my files. [/INST] Doctor:Hello. I have seen your reports. (attachment removed to protect patient identity). MR arteriogram shows The intracranial parts of both internal carotid arteries appear normal in caliber. There is hypolplasia of the A1 segment of the right anterior cerebral artery. The proximal left anterior and bilateral middle cerebral arteries and the arteries of the circle of Willis are normal in caliber. The right posterior cerebral artery is hypoplastic. The vertebral, basilar and left posterior cerebral arteries and their branches appear normal. No aneurysm or dissection or vascular malformation. There is no obvious vascular looping around the bilateral trigeminal nerves in the cisternal parts in the given images. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes burping and dark green stool? Patient:Hello my name is Bonnie, my 6 year old daughter has been complaining on pain on right side for few months now. Her pediatrician sent us to a GI Dr. She was on zantac, now prevacid 24hr twice a day and no relief. Shes still burping food up and now her stools are dark green. Could we be missing something? [/INST] Doctor:She has infectious gastroenterocolitis. I suggest-cefixime 4 mg/kg/dose twice a day for 5 days;-visilac 1 capsule once a day for 1 month;-enzymes syrup for 14 days-rice diet-ORSWishing you daughter speedy recovery </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Have hemangiolipoma in right kidney. Can there be a blister, possible lipoma on back? Patient:OK I have a 1cm hemangiolipoma in my right kidney (USN due in a month) I have what appears to be a small (2 cm?) blister like lipoma on my back. I had a frined take a picture of it beacuse I can t get a good look in the mirror. I am an RN and did some research and know that these lipomas can also show up in the brain and lungs so why not the skin? Isn t one question free? [/INST] Doctor:Hi, Angiomyolipomas of kidneys are known to be associated with an entity called Tuberous sclerosis which can manifest with skin lesions. These are usually seen as crops on face and the angiomyolipomas also are seen in both the kidneys in such patients. Without actually having had a look at the lesion on your back it will be difficult to predict what it could be, but it does not sound like a tuberous sclerosis lesion at present. Your being an RN makes it easy for you to understand medical literature, and thus if at next USG, your doctor picks up an enlargement of the angiolipoma or if there are fresh ones, you should be concerned and discus with your urologist as to the next step. If there is no growth of the lesion, and it is less than 2cm, i suggest you can wait and watch if you have no symptoms. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Having black pigmentation under eye. Not using any face cream. How to remove this? Patient:Thank U Dr. My name is XXXXXXX, I am 41yrs old, I have an problem in face under eye there is an black pigmentation like straight line under both eye, if there is any problem it is very ugly to see to, and In my lip there is an white pigmentation. And important is I have an sensitive skin . So I am not using any face cream. what is the probelm. Please solve my probelm Doctor. Thanking you ROSY [/INST] Doctor:Hello and Welcome to Healthcare Magic. Thanks for your query. Common causes for having dark pigmentation under the eye are: -Iron deficiency anemia -Stress, anxiety or depression -Lack of sleep, poor sleep hygiene -Poor water intake -Smoking and alcohol -Chronic illness -Unknown causes (idiopathic). So, it is important to identify specific and treatable cause for best result. In most of the cases reasons for having dark circles below eyes are multiple and that's why multimodal approach becomes necessary for the treatment. General treatment consists of: -Iron and B complex vitamins -Apply almond oil around eyes in night -Put slices of cucumber above your eyes daily for 15 minutes -For stress (if present): daily morning walk, meditation and yoga -Proper sleep for 7 to 8 hrs per day, follow sleep hygiene -Plenty of water, fresh fruits, vegetables and salads intake -Using sunscreens: if your skin is sensitive for sunlight If above steps failed (which is less likely), then you should visit dermatologist for treatment options like: Medicines, Chemical peeling and Laser treatment. Best wishes, Dr. Sheeba Stephen </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Missed taking the Femilon tablet, had sex. Missed tablet on the 11th day of my cycle. Will I get pregnant? How to avoid it? Patient:Hi,I am taking femilon tablet for the past 2 months to avoid pregnancy..But for the third month i missed taking the tablet for one day . Me and my husband had sex that night and i am really worried about the pregnancy now?can you let me know the status my condition ? is there any way to avoid it now ?Please Note : Missed taking my tablet on the 11th day of my cycle.Please advise.Maks [/INST] Doctor:hello,thank you for using health care magic,well if it is less than 24 hours since when you involved in unprotected sex take emergency contracertive pill asap.. take its another dose after 12 hours of first dose..if it is already more than 24 hours consult gynecologist and go for IUD insertion.. if you get IUD inserted with in 5 days of unprotected sex than there are rare chaces of pregnancy...in future if you forget to take pill take it as soon as you remember and continue it in rest of cycle normally..plus for that particular cycle use additional method of contraception like condom..hope this helps you,..Regards,Dr.Nehal.. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What could back pain while on HCG diet indicate? Patient:Hi, may I answer your health queries right now ? Please type your query here...I ve been on the hcg diet and have horrible back pain acoss the shoulders and lower neck, friend is having the same pain she is on phase III of the diet with a lose of 33 pds, I ve been on it for 25 days with an 11lb lose. Why?? [/INST] Doctor:Hi there.You should be on a balanced diet of adequate proteins, fats and carbohydrates. Also important to keep well hydrated during hCG therapy. If you are intolerant to this diet, you may need to caese it. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest remedy for pigmentation on face Patient:Hi my name is Elena.. i have a problem of pigmentation on my face and getting more and more i sed cream lightenning but this there i used few but just not going away ... i did used laser but not happenning,,, could u pls help me coz both of my face are nearly covered.... thank u so much [/INST] Doctor:Hello,Melasma is a kind of hyperpigmentation seen mostly in females of middle age and is dictated by hormones and sunlight.It treatment is challenging but with proper regimen good results can be achieved.Usually the treatment is divided into clinic based treatment and home based.At clinic, I suggest series of chemical peels like glycolic, Jessner, TCA with or without microdermabrasion.At home you can apply cream containing kojic acid, arbutin, etc and vitamin C serum for maintenance.Use high SPF sunscreen on regular basis.Use glycolic acid based facewash.Hope this will take care of your issue.Dr Hardik Pitroda </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Q. What can be done to manage discomfort caused due to wisdom tooth eruption? Patient:Hello doctor, I am getting wisdom teeth at the back of my mouth. Now I am 22. But I am teething and it feels uncomfortable. What to do to get relief from it? [/INST] Doctor:Hi. Wisdom tooth eruption will occur periodically. You will feel pain and pressure in months. For relief, you may take tablet Brufen 400 mg twice a day for three days. Put oral gel Clinica (Chlorhexidine with Metronidazole) three to four times a day for a week in that particular area. And lastly that is most important, do saline water mouthrinses three times a day for two weeks. It will relieve the soreness of gum areas. Take a 1/4th teaspoon of salt in a cup of lukewarm water and do its rinses. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest treatment for rapid heart rate and high pulse rate Patient:Hello doctor. I am 28 years old. Have a son 7 years old. I started having a constant heart beat of between 112 and 117 beats per minute. At first i thought i was unfit. I bought a trojan exercise bicycle and tried to ride that. My pulse then goes up to 163. I then stopped because i dont know if its dangerous.. should i seek medical help? Or maybe just by Cardio care disprins? Please help? [/INST] Doctor:Check ur thyroid hormones and get an ECG. Do u feel irregular pulse/heart beat sometimes ? Do u have palpitations? Blood pressure? Revert back & also get examined by physician . </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What can cause swelling around the navel and pain below the ribcage? Patient:I have swollen abdomen around belly button, about 5in diameter and moderate to severe pain bellow ribs and lower back. also have indentation on left below ribs about 1in deep. Had gallbladder removed last year. are they connected or what could cause this? [/INST] Doctor:Hi, Please understand that this is not related to gallbladder directly. I advise you to undergo X-ray lumbar spine AP and lateral view to rule out lumbar spine disease. Also get ultrasound abdomen to rule out any pancreatic disease. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Varinder Joshi, General & Family Physician </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Having blood blisters pop up on hands occasionally. Reason? Patient:I ve been having blood blisters pop up on my hands on occasion. They last only a few days, fade away and appear more like liver spots, then disappear. There s no pain. I take various meds for fibromyalgia and have been having dental problems with implants that aren t taking properly. I have an artificial hip. Because of the dental problems and fibromyalgia onset after hip surgery, my oral surgeon had me tested for metal allergies. I m highly allergic to palladium, but not titanium as he had feared. [/INST] Doctor:i think allergic to foreign material as the implants are not pure as if something is mixed in that you will have problemsor medicines like ibuprufen paracetamol calcium diet suppliments can be causelocal ointments creams shampoo soap or foodscan get guidence from allergy specialist who can find the cause after testsand treat your </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Have follicular lymphoma, sciatic pain. Treated with rituxan. Could this be the lymphoma? Patient:I have Follicular Lymphoma ( initially large cell follicular ) treated with R CHOP and put in remission for 3 years. Relapsed one year ago with follicular only and treated with Rituxan. Had a 3 month remission and than relapsed. Being treated again with Rituxan. Cancer returned to left side of neck and clavicle both relapses. However--I am now experiencing sciatic pain ( with no cause) could this be the lymphoma? 38 years old female [/INST] Doctor:Hi,Follicular lymphoma is a indolent disease, so the patient leaves with a disease for a long duration. Although the involvement of bone is rare, it can involve any part of the body. You need to undergo MRI of the spine to see for the cause of sciatic pain.It may also give a clue if there is relapse of lymphoma to spine and bone scan also may show the uptake. The involvement of spine can be conformed only with biopsy of the lesion. With the presence of disease elsewhere in the body, biopsy of spine may not be required and requires treatment for lymphoma.Hope i have answered your question. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest remedy for persistent dizziness Patient:This week I got dizzy twice this week. First time I was sitting watching tv and it went away in 1 minute or so and the second time last night again got dizzy watching tv with my eyes dizzy not seeing tv with any stable gaze (dizzy) and got to a point within 3 minutes wanting to faint but didn t and pulled out of it within 5 minutes and was normal again. I was having back problems at that time and was sitting stretching my hamstrings at the time to loosen up the back and the dizzyness came on. I stood up to call a friend and was dizzy standing too. [/INST] Doctor:Hello Thanks for posting to HCM.Consult to neurosurgeon.Do CT scan head.Take medicine .....Tab. Vertine 8 mg Twice a day..Test your Blood sugar levels and Blood pressure.Regards.Dr.Sharmila Boora. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Is surgery the only option for cerebrospinal fluid blockage? Patient:Hi,      Doctor I am writing this queries for my firend, he has been suffering from menintise, Now docters saying Cerebrospinal fluid is blocked in one valvem, and it is necessary to do a surgery for inserting shunt.      Is there any other option for cure this dusease ?      Is there any risk on fixing this shunt ?      Is this fixing for lifetime ?.            waiting for your response      Thanks      friend [/INST] Doctor:Hello, Surgery will be the treatment of choice. If you delay the procedure, the pressure inside the brain will increase rapidly and it will cause adverse effects. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, 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 spasms and shortness of breath? Patient:My daughter is 10 and started having spasms and shortness of breath 3 weeks ago. This happens when she is going to sleep or in her sleep She has recently started hallucinations two nights ago. what can be causing this? A neurologist has prescribed Valparin for a two week trial. [/INST] Doctor:Hi... I feel that your child might be having a condition called PANDAS, which is related to the neuropsychiatric manifestation of streptococcal infection. I suggest that you go through about this illness in the Internet and with this tip consult your Neurologist for reconsideration of the diagnosis.Regards - Dr. Sumanth </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What to do if kid drank small amount of piriton? Patient:My 3 yr old has just drank a small amount of piriton from the bottle i do not know how much, but i know there was not much in the bottle, there was less then a 1/4 bottle but i wondered how much is a dangerous amount and should i take him to the hospital, [/INST] Doctor:HiWelcome to the HCMPiriton syrup has Chlorpheniramine drug. In my opinion you should immediately go to ER as you are not sure about the exact amount taken by the child.Chlorpheniramine is a sedative drug and may lead to many side effects at high doses which needs careful monitoring and management accordingly.The estimated lethal dose of chlorphenamine is 25 to 50mg/kg body weight. Symptoms and signs include sedation, paradoxical excitation of the CNS, toxic psychosis, convulsions, apnoea, anticholinergic effects, dystonic reactions and cardiovascular collapse including arrhythmias.Symptomatic and supportive measures should be provided with special attention to cardiac, respiratory, renal and hepatic functions and fluid and electrolyte balance. For further questions, you may contact me.Take care </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What does bumps on armpits and behind knees in a baby indicate? Patient:My 8mo old has several flesh colored bumps in his armpits, elbow creases, and behind his knees. I noticed a few in his armpit 4 days ago and they seem to be spreading quickly. Some are turning red and look like they re scabbing over. What could it be? [/INST] Doctor:Hi...by what you quote it seems like the kid has contacted a hand foot mouth disease. There may be some ulcers and similar lesions in the mouth too. Kindly check and if so it is almost confirmed. Usually it is a self limiting disease and trivial viral infection. Do not apply anything on the skin as it can spread the lesions. The best way is to give some over the counter antihistamines before consulting your docotr and in 4-6 weeks you should be expecting a skin peeling too and do not think that it is another unrelated skin disorder. Regards - Dr. Sumanth </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What do red spots on the tongue indicate? Patient:what can cause red pimple spots like little scaly soar no pus and come in your inside of your jaw and on tip of tongue. I was told I had rheumatoid arthritis/ lupus with psoriasis. The only thing I was given at the time is some methotrexate, it did no good. [/INST] Doctor:Hi.Thanks for the query..Your symptoms are appearing like those of mouth sores or mouth ulcers..It can be due to a number of causes like Vitamin B 12 and iron deficiency, eating plenty of sour or spicy foods, tobacco chewing habits, any sharp cusps of teeth causing mucosal injury etc.So my suggestion is to start gargling with warm saline solution.Avoid spicy and acidic foods..Take Vitamin B complex supplement daily..Do soda bicarb rinses.If there are any sharp cusps of teeth get them.smoothed..Drink plenty of cool water..Hope this helps..Regards.. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Does hardness and redness around wound indicate infection? Patient:Hi I cut my shin on my left leg last sat on a melal pinic table it was a tiny cut so i did no more but it still has not scabed over and its very hard to touch all around it? ther is also a red mark all around the bit where the skin was taken? would you think this is infected/ [/INST] Doctor:Hello,Thanks for posting your query.It takes 3-4 days to be scabbed.However only after examination it is decided whether wound is infected or clean.So consult your Doctor for further intervention.Take care </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest treatment for water retention Patient:Hi i am taking Oroxine tablets and i am suffering from water retention in my body, my feet are swelling to a degree i can t walk. I consulted with my doctor, he prescribed me medication for water retention i can t keep taking the water retention tablets all my life. are there any other medicine which doesn t have water retention as a side effect? regards [/INST] Doctor:Hello and welcome to HCM.As an Urologist, i can fully understand your concern.Oroxine is a treatment, which one needs to take for a lifetime.But, blood levels of TSH and Free T4 , need to be monitored every year, or earlier, in some cases.You should also check your blood sugar, creatinine, sodium, potassium, lipid profile , urine routine , and blood pressure.You're welcome to contact me by name, with the reports.Wish you well. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Rashes on thighs, patches under breasts, spreading to upper body. Taking steroids, became worse. Treatment? Patient:I have a rash that started small on the outside of one of my thighs and a few small patches under both breasts now its spread all over upper body my back by my crouch hips arms pits inner part of both elbows and my buttocks its growing and spreading please help me as to what this might be I ve had this problem for a month steroids made it worse please help me [/INST] Doctor:hi, according to your description there is possibility of, -fungal infection, -seborrheic dermatitis, -atopic dermatitis, so you better visit local dermatologist and get examined to find out the actual cause and nature of the rash, depending on that treatment can be taken, usage of steroids with out doctor's advice will decrease the immunity and make problem more severe, so don't do that. take care. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest treatment for high blood pressure and sweating Patient:PLEASE PLEASE HELP. FOR 3 DAYS A MALE IN HIS MID FOURTIES WITH A HISTORY OF HIGH BLOOD PRESSURE HAS BEEN WAKING UP COMPLIANING OF NAUSEA AND SWEATING. HE WENT TO THE EMERGENCY ROOM AND THE GAVE HIM A POTASSIUM PILL, BUT TODAY HE COMPLAINED OF IT AGAIN. HE HAS A HISTORY OF HIGH BLOOD PRESSURE, BUT A NIGHT AGO, IN THE EMERGENCY ROOM HIS HEART BEAT WAS AT 53. WHICH IS GOOD. HE EXCERCISES, BUT CARRIES A LOT OF WEIGHT IS HIS ABDOMINAL AREA. WHAT SHOULD WE DO? [/INST] Doctor:Hi,How much was his blood pressure during sweating episodes, was it too high? Possibilities are, there can be excessive rise in BP which is causing his symptoms. Secondly it may be due to slow heart which may be very low during sleep leading to symptoms, is he on any beta blockers or drugs which decrease heart rate. If yes, it should be stopped. Also one thyroid tested is needed. If both of above is negative then he may need holter monitoring. Also his troponin and ecg is must. He should follow healthy lifestyle like avoiding fatty, oily and high calorie diet. Have low salt diet and monitor blood pressure and pulse rate regularly thrice a day for one week then once or twice a week. Regular exercises like brisk walking, jogging according your capacity at least 30 minutes a day and 5 days a week. Eat lots of green leafy vegetables, fruits, fish once or twice a week, avoid meat. Avoid smoking and alcohol if any. There shouldn't be abdominal fat deposition or obesity. High risk activity like driving should be avoided til diagnosis is confirmed.Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Sagar Makode </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes dizziness and nausea in a child? Patient:daughter is nine...for past two years complains of periodic dizziness and is usually accompanied with a low fever...this happened again yesterday and she said she felt nauseas. It comes and goes... Pediatrician said she gets this way when allergies act up...I dont know that I agree. [/INST] Doctor:may be csom(chronic suppurative otitis media) more common in this age as by ur history cold, low grade fever. u should check her ears by an ENT specialist to rule out the condition. tab like sturgeon vertin may help her in aeilating her symptoms of dizziness. and tab montelukast may be used for cold and allergic purpose. a course of antibiotics can b used for treating her ear infection.feel free to ask any queries. thank u. . </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Does a good diet and exercise help with a fatty liver? Patient:Q : Hi, I had recently test my ultrasound scan found early fatty changes in liver. Then I had a LFT(liver function test) That is Total billirubin 1.20, Conjugated billuribin 0.29, A.S.T.(SGOT) 56 A.L.T.(SGPT) 89 Alkaline phosphatase 159. In my Lipid profile shown that Cholesterol 227, triglycerides 290, HDL cholesterol 39, LDL cholesterol 130 VLDL 58. Doctor prescribed the medicine named as Hepexa M, Fibator EZ, VSL-3 Rabium dsr for 3 month,. i had already avoid alcohol, fatty foods and controlled a lot of my diet having exercise, after 2.5 month i lose 8 kg weight (81kg to 73kg), now my lipid profile is normal,may this type of case occures after heavy diet control and above medication use in 2.5 month, my age 33, height 5.6 inch [/INST] Doctor:Hi.thank you for posting query at HCM.definitely, exercise and strict diet along with medication aids in weight reduction and improving the abnormal liver enzymes reading. however, you need to monitor your liver enzymes and lipid profile every 6 months to 1 year.secondly, visit your treating physician and take his advice for discontinuation of drugs and/or dose adjustment. Prevention is better than cure. So, try to maintain ideal weight to avoid complications of being overweight.any further questions are welcomed.hope to answer your concern.wish you good health.regards,Dr Tayyab Malik </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Redness of roof of mouth near teeth and gums, had taken antibiotics for UTI. What could cause this? Patient:For the past couple days, I have had redness on the roof of my mouth near my teeth and gums. I did try some medication for canker sores and have used it twice. The brush applicator causes the red area to bleed when. Any suggestions as to what this may be caused from and how I can treat it? I was on antibiotics for a few (2) days; I took bactrim for a UTI . Please help. Thanks. [/INST] Doctor:Hi, I read your problem.See, mouth sores can be due to stress or vitamin -B deficiency.For mouth sores, use topical anaesthetics that contain benzocaine, lignocaine, tetracaine will help to relieve from redness of gums.Also take vitamin -B complex.Don't stop antibiotic course for UTI. Use soft bristled brush and mouthwash also.I would advice you to visit your dentist also. Have a nice time... take care </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest remedy for hard lumps on hip bone Patient:I have a hard lump to the right of my left hip bone. Hurts to push down on. I recently had some lingering cramp pain in my lower stomach for 3-4 days. Almost like achy. I also had my period 2 days late this month for 7 days then had a period again 2 weeks later. I am on birth control but just started it again 2 months ago or so. Doesn t hurt to pee or anything and no stinging pain. I did notice after intercourse I smelt kinda off from my normal for about 1 week. Is this lump normal for girls? What is it? [/INST] Doctor:Hi, thanks for sharing your health concerns with HCM! If I were your treating Doctor for this case of hard hip bone lump, I would come up with three possibilities, these include: 1.     skin or hair follicle infection due to some friction injury 2.     The second possibility is of an ischiorectal abscess      3.     The last possibility is of some infected cyst or benign tumor / tumor like condition Overall, it is inflammatory and not worry about this!I suggest you to go for ice/cold compress in the region with local hygiene and take some topical antibiotics and wait for 2/3 day; if not relieved please don't forget to write to us again...Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes green stool and severe cold in infants? Patient:Hello doctor, My baby is 3.5 months old and she is passing her stools in green color from past 2 weeks. She is exclusively on breast feeding. I tried babylac, econorm with ofloxin metronidazole suspension 0.5ml for 3 days but it didn t helped. I consulted another doctor who has given zinc powder 0.5ml a day for 14 days, enterogemnia 5ml twice daily for 3 days and walamycin suspension 0.5 ml for 4-5 days. I didn t see any result even after using that for 2days as still she passes her stool in green color and watery.My baby weighs 5.2 kg approx My baby activity is normal. Now she has even severe cold.as it s been 2 weeks I am worried a lot.. Please help [/INST] Doctor:HiWelcome to the HCMThe breastfed baby's stools may change in color, and baby may even have an occasional green stool. Consistently green stools, however, may indicate a problem, such as imbalance in foremilk/hindmilk, or sensitivity to something in mom's diet, such as dairy. Green stools do not always indicate a problem.If your babies activity and weight gain is normal, it is very unlikely to have green poops due to some infection. So in my opinion there is no need for any medical treatment. Only check if he is properly breastfed and is getting hind milk properly.Whether your child has a cough, a cold, or the flu, you can try these gentle, effective, and safe home remedies:1.Have a humidifier or a cool-mist vaporizer going in your child's bedroom when she's sleeping, resting, or playing in the room.2. Saline nasal Drops easily available help clear the nose when kids are too young to blow their nose. For babies, a bulb syringe really comes in handy if a stuffy nose interferes with breastfeeding or bottle-feeding. Try using it about 15 minutes beforehand.3. Vapor rubs.If still child continues to have cold, try phenargan syrup 2.5 ml twice daily for3-5 days.In case of any further questions, do call back. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes pain in the mouth, gums and throat of a diabetic woman? Patient:I m a 55 yr. old female, diabetic last 35 years and am experiencing sore like pain in my mouth, gums, tongue, throat although there are no visable sores. I m on Zolpidium, Tramadol, Hydroxyzine and Omeperozal. My teeth enamel seem to be thining and some teeth are very thin close to my gums. What can it be ? [/INST] Doctor:Hello,People with diabetes are more susceptible to developing infections, as high blood sugar levels can weaken the patient's immune system defenses. So, people with diabetes are at a higher risk for gum problems because of poor blood sugar control. At the other side, as with all infections, serious gum disease may cause blood sugar to rise.In my opinion you may have a periodontal disease .This is the most common dental disease affecting those living with diabetes and your pain can be a sign of mouth problems caused by diabetes. My advice for you is to consult your dentist as soon as possible and keep your blood glucose numbers as close to your target as possible.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Elona Xhardo </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: How to heal post waxing redness? Patient:My daughter had her eyebrows waxed 5 hours ago, and the area just below them is still very red. I put hydrocortisone on them about an hour ago, and she said they've stopped hurting; but they're still red. Should I be concerned or do anything differently? [/INST] Doctor:it can be post inflammation, and hydrocortisone takes it regular time to heal. you can apply it one more time after 7-8 hrs.redness will go </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Kidney stones, taking cap, loose motions. What action should i take? Patient:Hi I am Rajesh & for the first time i am facing problem while passing urine & i have under gone x ray , urine test , blood test . x-ray says there is no stones in the kidney , after that doctor directed me to take more water & KMG cit to mix in the water & have 3 times a day & two types of tablet which are meftal spas , OMTECH D. after taking these medicenes i am experiencing loose motion please adivse the action to be taken. [/INST] Doctor:KMG Kit has the side effects of loose motions because Magnesium citrate absorbs more water from the intestines and this follows loose motions. You have not clearly mentioned for how many days you are using KMGkit. It should not be used for more than 5 days. If you experience adverse symptoms please consult your doctor ASAP. Mefthalspas and OMTECH-D doesnt cause loose motions. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest home remedies to reduce abdomen pain after taking mifeprin kit Patient:Hi Doctor,My wife, who is a pregnant of 7 weeks has taken Mifeprin KIT on doctors advice as there is an issue with the baby/foetus. Now, my wife is suffering with heavy bleeding and she is complaining of heavy pain below the stomach. We would like to know if there is any home remedy to reduce the pain?Thanks in advance. [/INST] Doctor:, don't try any home remedies now. have an immediate visit to your obstretician this heavy bleeding is due to abortion of the fetus. all the time it might not have aborted fully and she may need Dilatation and Curettage. any left out contents inside the uterus will cause severe bleeding. so immediate medical attention is needed .Natural remedies will not work this time.hope this explains.with RegardsDr.Amarnath </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes severe mouth twitching? Patient:My mom had tremors. I think it is starting for me. Also when I am laughing hard my face around my mouth twitches so violently. It is very noticeable and embarrasing for me. I then try and control my face not to laugh. Does this seem like tremores to you? [/INST] Doctor:Hi..Welcome to HEALTHCARE MAGIC..I have gone through your query and can understand your concern..As per your complain lip/mouth twitching also known as Lip Fasciculations is an involuntary contraction of lip muscles and can occur due to a number of causes like injury or inflammation of facial nerve that supplies the muscles of face, panic attacks, anxiety, deficiency of potassium and electrolytes,viral infection, Facial nerve palsy , increase in levels of parathyroid hormone, Parkinsonism etc..I would suggest you to consult a Neurophysician and get evaluated and he can do a thorough clinical evaluation along with investigations like MRI SCAN, blood tests, Electromyogram, Nerve conduction velocity etc to rule out the exact cause of the symptoms and treatment of underlying cause can relieve the symptoms..As of now you can take a nutritious diet with multivitamin supplements and high Potassium containing foods like banana, watermelon etc..Keep stress minimal by doing meditation and breathing exercises..Do warm compresses over the lips and the areas that twitch..Limit intake of alcohol, tea, coffee etc..Hope this information helps..Thanks and regards.Dr.Honey Nandwani Arora. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Is mycrogynon pill safer than depo shots? Patient:I am currently using the pill injection as contraceptive, used for 3 months but do not like it. I have 3 months worth of mycrogynon pills which I would like to use again, have used this for 10 years and i have 2 children within his time so it works for me. My depo is due Monday 23rd jan, when should I start taking the mycrogynon again? Thanks [/INST] Doctor:Hi,Yes, you can start your hormonal contraceptive on the day that you are due for a Depo shot. Because Depo-Provera remains in your body for up to 15 weeks after your last shot, you can start your first birth control pill at any time. For the first seven days of using the pill, I would suggest you to use an additional method of contraception such as condoms since the pills can take 7 days to become fully effective.Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Saranya Ramadoss, 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 do swollen gums and an ulcer on the tongue indicate? Patient:2 days ago i started with swollen gum around 1 tooth the day after my gums are swollen everywhere and i am beginning to feel cold but i am burning hot and also have a red soar on the tip of my tongue.. i brushed the soar on the tongue.. it is white now but bugger and still swollen gums (bleeding a little bit)and i notticed a small red or white spot (like on my tongue) but on my gum between 1 toothand my neck is soar where my tonsils or glands are..plus i am starting to have a small discomfort when i swallowi am starting to worry [/INST] Doctor:Hi..Thanks for the query..Swollen and bleeding gums with pain and ulcers on tongue can be due to viral Infection..It can also be due to allergies..So my suggestion is to consult an Oral Physician and get evaluated..If Allergic reaction is suspected you can be advised antiallergic medication, Steroid shot and warm saline gargles..Gargles with 1:1 solution of milk of magnesia and benadryl can help..Do cool compresses over the gums..Do antiseptic mouthwash gargles..Use soft toothbrush to brush your teeth..If it is due to Viral infection antiviral medication like Acyclovir can be advised..Hope this helps..Regards.. </s>