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<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Q. Can HIV symptoms occur within a month of exposure? Patient:Hello doctor,I fear I may have contracted HIV. A month back, I had oral sex and regular sex from an unknown girl. Three days later, I started to feel very sick, headache, cold in warm weather, tired, diarrhea, sweating in bed (I thought this could be food poisoning). A week later I felt better but had breakouts on my whole back (thought maybe from sweating in bed and training in severe heat the past week). A week back, I felt fine most of the day but once 4 PM hit, my throat started to hurt, I had a severe headache, cold sweats, very tired, fever at 102 F. Felt better by the next night except for the throat which still hurts when swallowing. My neck feel kind of stiff as well. I wondered how much stress can play a factor in producing symptoms, because the first time I was extremely stressed for a couple hours about something and the second time the same thing. And I mean extremely stressed out and anxious, thinking alot, heart racing, etc. I of course will get a test but fear it is too early to show a positive result if it happens to be. [/INST] Doctor:Hello. I have noted your concern. Unprotected oral is not much of a risk. The only risk factor involved here is regular sex. The breakout on your back looks like acne (attachment removed to protect patient identity). Your throat symptoms and other systemic symptoms could be just part of throat infection. I suggest you take a fourth generation HIV screening test at four weeks from your risk exposure with the girl of unknown HIV status. That would be conclusive. For more information consult a venereologist online --> </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What can cause numbness and swelling on the feet and toes? Patient:I have numbness in my feet. a bit of swelling and the top of my toes have a burning tingling sensation. I am trying to pass a kidney stone and have had lots of urinary tract infections and even at times feel the urge to urinate but drops only ever come out, and the urge to pee is still there. I may also be a boarder line diabetic I have gotten treated for the urinary problems but my feet are still swelling and the top if my toes still burn and tingle. I have been experiencing a lot of severe back pain as well .What is going on with me? [/INST] Doctor:Hello, Consult an orthopaedician and get evaluated. Most probably it’s due to neuropathic causes. 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: Suggest alternate medicine or therapy for psychotic episodes Patient:My daughter (28years) had a phsycotic episode in 2005 has been on sodium valproate since ten developed difficulty in sleeping for the past month doctor changed her medication to lamitor (75mg) for the past 2 weeks. She has a very bad skin rash and palpitation; the doctor says it will clear. Can she get alternative medication or other forms of therapy? [/INST] Doctor:HiThanks for using healthcare magicIn psychotic episode, there is no need to give mood stabilizer in first attempt. Both valproate and lamitor are mood stabilizer and with them, she would not improve. She need antipsychotic agent and that would help to control her psychotic symptoms. Better to consult a psychiatrist for proper treatment. In case, you need further help, you can ask.Thanks </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest treatment for constipation in an infant Patient:Hello. I am a desperate mommy! My 11week old has silent reflux. He was on novalac ha and did very well with the milk. No gas. His tummy went daily. Then i put him on nexiam which made him constipated. My paed said to stop with the nexium and use novalac ar,now he is gassy and fussy and even more constipated. He is suffering. And i am going back to work next week. Need sleep. Will nestragel help?! Can l put it in the novalac ar? I heard that it also helps to soften stools. Please help [/INST] Doctor:VERY GOOD QUESTION,FIRST OF ALL I WANT TO KNOW HIS FEEDING SCHEDULE AND WHAT YOU ARE GIVING ,IF YOUR BABY IS FORMULA FEED THEN CONSTIPATION IS LIKELY PROBLEM OFTEN WITH FORMULA FEED,BUT IF BABIES ARE ON MOTHERS MILK THEN THEY MAY HAVE MOTION FREQUENTLY,OR THEY MAY PASS MOTION BY 2-3 DAYS BUT MOTIONS ARE SOFT IF YOU FEEL NOVALAC IS HELPFUL ADJUST PROPER DOSE PROBLEM WILL BE SOLVED </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Is Lyco-Q 100 tablet appropriate for improving sperm count and motility? Patient:hi dr i am 33 year old my sperm count low 1 ml =7 million and motility 10% how can increase count and motility how to work lyco-q 100 tablet this tablet in crease count please tell me thank you . my email id : YYYY@YYYY [/INST] Doctor:Hi.Thanks for writing on HCM.Lyco Q 100 contains antioxidants (lycopene, ubidecarenone) which boost your sperm health, increases sperm count and motility.These supplements take 3 to 4months to work.Hope this answers your query. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Will taking Lisinipril cause constant coughing? Patient:tried lisinipril for high blood pressure caused constant coughing. I am now on losartan, now I have restless legs at night with some itching so it is hard to sleep. What would be a good alternate drug for my high blood pressure? My doctor prefers those two drugs to others because they also offer protection for the heart. [/INST] Doctor:Hello I have gone through your question .if you are allergic to both lisinopril and losartan then you may switch on to amlodipine after consulting your treating doctor.But before that you should rule out any other allergic condition.My best wishesDr.Teli,MD </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Should I be concerned for upper right back pain,getting greenish phlegm when coughing or sneezing? Patient:i have this upper right back pain that has never been going away for quite some time now, i suspect its my lungs and now i have this cough that when i sneeze out and take out phlegm its greenish. i have been complaining for my back pain eversince and even without a cough before, i wanted to have a chest ct scan to see if theres nothing serious [/INST] Doctor:NamastheWelcome to Healthcare-MagicGreetings of the dayGet an Chest X-Ray and take opinion about the same before embarking on CT scanIn case you need any further assistance, will be glad to assist you.Wishing you happy and healthy lifeTake CareBest RegardsDr Deepak K KMBBS,MS,MCH </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Need treatment for pus coming out from lower gum Patient:Last year I was referred to a dental specialist as I had pus coming from my lower tooth/gum and he found that the tooth was fractured under the gum & so took the tooth out & all was well. However, I now have some white sticky (pus?) coming out around a top crowned tooth. I push my gum several times a day to expel this sticky substance. However, the problem I have is with my current dentist who I have been wish for approx 9 months. Every time I have told him about this problem he says that he cannot see anything coming from my gum & is very reluctant to investigate further and told me that because of the previous problems I had I am being paranoid. I just dont know how to deal with this - should I change dentists? [/INST] Doctor:Hi, In my opinion u should take an opinion from another dentist prefeably an periodontist who specialises in gum diseases, Wat i understand from ur symptoms is 1) it could be a mild gum infection in which v smallamount of pus oozes out on pressure this can result in loss of bone support to the teeth...can be treated easily with deep scaling n antibiotics if early..2) it could be food debris lodged in the gum pockets around n beneath the crownwhich may be expelled on pressure.but best to see a good dentist and with an xray n good examination can be diagnosed.all the best </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Is pregnancy possible after tubal ligation? Patient:Hi my name is Ariana,I had my tubes cut and burn after my second child who is now 3 years because I had to financial support from my ex. I met a wonderful man who I m now married to and regret having tubal ligation because he has not any children. I would love to at least have one baby by him. Please help me. [/INST] Doctor:Hi, I think there are two options for you. One is recanalization, but as your tubes were burnt , so chances of success is a little bit low. 2nd option is IVF. The chance to get pregnant in one cycle of IVF is 40 to 50 percent. Hope I have answered your question. Regards Dr khushboo </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest medication for elevated cholesterol level in blood Patient:doctor I am 66 years old, I smoke a lot but physically I feel fit I exercise regularly, I have no health problem except hypertension, I am on Calan SR for the last more than 20 years, my colestrol level was slightly high so I consulted a friend also a doctor who advised me my to take loprin 75 mg which I took for about 4 years on daily basis then I realized my colestrol/lipid profile is normal I consulted the doctor, he advised me take loprin on alternate days, which I am doing. how is it what do you advise sir. [/INST] Doctor:Hi there... Pls dont feel bad but tab.loprin 75mg(aspirin) is an antiplatelet drug usually prescribed for heart disease patients(ihd) or for its prevention... There is no role of loprin in reducing cholestrol level... So if ur cholestrol level is high start with atorvastatin or rosuvastatin.. Take care.. </s>

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

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Should men wear under wear during exercise? Patient:Is it required for men to wear an under wear during exercise? Will there be any negative impact if the underwear is not worn during exercising like stretching, weight lifting etc. I am 40 years old, weigh 90 kg and with a height of 6 ft. I am sound in health and has no regular health issues. [/INST] Doctor:Hi, it is recommended to wear tight underwear or Supporters during exercise. This is done so that the testicles dont get hurt by excessive movement or trauma of any kind. So, I suggest you wear Supporters during exercise. Take care,Dr Rishi, New Delhi, India. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Is there any chance of pregnancy after having unprotected sex? Patient:Hi, I am on microgynon and have been for some time, i am very carefull and i never miss any of the pills. I was given trimethoprim for a water infection and i took the 7 day course in line with my 7 pill free days. i read on the leaflet that i should have protected sex throughout the course of the antibiotics and then 7 days after. I then had sex two weeks after unprotected and am now due my pieriod again, however i am late. Is there any chance i can be pregant?Regards. Josie. [/INST] Doctor:you have to check once just to confirm .after that you have to go for pills again after normal cycle. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes hallucination with disturbed sleep? Patient:I AM 72 YEARS OLD.I AM 5 7 .I WEIGH 198 LBS.I HAVE A FIB,HIGH BLOOD PRESSURE,HIGH CHOLESTRAL AND HAD PROSTATE CANCER AND WAS TREATED WITH HARMONE SHOTS AND CYBER KNIFE TREATMENT.MY MD. SAID MY BLOOD WORK SHOWED THAT I WAS ANEMIC.I GO TO THE BATHROOM 7-8 TIMES A NIGHT AND IM VERY RESTLESS WHEN I SLEEP.I AM HALLUCINATING.I SEE PEOPLE AND ANIMALS THAT ARE NOT THERE.COULD MY KIDNEYS BE MAKING ALL THIS HAPPEN? [/INST] Doctor:Hello. Thanks for the query. Brief answer is NO. Detailed answer is based on your age (72 years), associated illness (hypertension, dislipidemia etc.) presence of hallucinatory experiences might occur due to dementia which is a condition characterised by gradual onset memory difficulties, difficulties in carrying out previously learned activities, restlessness (anxiety symptoms), mood fluctuations (sadness-irritability), difficulty sleeping, vague suspiciousness, hallucinations etc. Similar symptoms may also occur in a rapidly developing condition known as Delirium also. But in case of delirium the symptoms fluctuate over hours. In dementia the symptoms usually persist. Hence kindly visit your primary health care doctor earliest & get your evaluated for both of these. Regards </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes severe cough, shoulder blade pain and heart palpitations while treating pneumonia? Patient:I have a pneumonia and have gone through 1 full round of a zpack and steroid. I m also using an inhaler, had to go back to dog on Thursday night because I was still not any better. They gave me a antibiotic shot and a 1/10day script for levaquin which I started about 10am Friday morning. I m still not feeling better. I now as of this morning have a sharp pain inbetween shoulder blades that comes and goes, my heart flutters sometimes and sometimes beats really fast, I also woke up to chest pain that would go from burning feeling to sharp pain for about 30 min consecutively, then stopped and has been on and off since then. My cough is so bad that when I cough it feels like my ribs/lower sides of my back/lung area are bruised/fractured and takes my breath away when I take deap breathes or bend my waiste. I noticed bout a 5 days ago that I would get really hot at random times. Ao thinking i was having a fever, I ve been keeping track daily of my bt as of about 3/4 days ago and it s seems to have steadily slowly dropped. It s ranging usually from 96-97 but sometimes it ll get to like 98.0 and thats while I m sweating so bad that s my shirt will be soaked and hair wet like I was standing outside in the sun for an hr in middle of summer. It s sick. Should I be worried? [/INST] Doctor:Respected user , hi Thanks for using Healthcaremagic.comI have evaluated your query thoroughly .* All symptoms are in relation with underlying lung condition giving rise to broncho alveolar constrictions , pleura irritation with systemic manifestations* As there is not much relief of oral medications given till now , I strongly recommend to get hospitalised treatment & early better recovery through IV antibiotics , bronchodilators, supportive nursing care Hope this clears your queryWelcome for any further assistance Regards . </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Q. Why do periods get delayed after first time sex? Patient:Hi doctor, I had sex for the first time. After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods? [/INST] Doctor:Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information 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 infant to keep vomiting after eating? Patient:I have a 10 month old son, who has started to projectile vomit every day at least 3 times a day. We have taken him off formula and put him on soya milk, which helped for a few days, but then started again. He s not refusing food and seems fine after vomiting. He was never like this as a newborn and this has only been happening over the last 3 weeks. Any suggestions? [/INST] Doctor:hi dearwelcome to the HCM,Overfeeding might have led to vomiting practices..Shift the baby to semisolids. milk only twice a day.Hope the query is answered.Thanks </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes backache along with chest pain? Patient:Alodokter I have a back pain then it s reflecting on my chest whenever the back is paining me the pains comes to my chest then I have a stomach ache together what can be the cause [/INST] Doctor:Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. For backpain you can see an orthopaedic surgeon. It can be due to muscle or ligament strain, some injury or lifting heavy weight. You can take Ibuprofen or combiflam for relieve from pain but you need to be examined. Make sure you are not constipated, take fiber & drink plenty of water. It can be gastritis that causes you such discomfort, take antacid and Pantoprazole -40mg once daily. But if you do not get relieve, you should visit ER, get Lipir function tests & ECG done to rule out any developing coronary artery disease. Hope I have answered your query, take care. Regards, Dr Nupur K </s>

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

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Why am I having dent on the top of my skull and tibia of my left leg? Patient:I just discovered a dent on the top of my skull that was not there just a few days ago. I haven t been in any accidents or hit my head! What s strange is that I have a dent in the tibia on my left leg that mysteriously appeared a few years ago, and there was no trauma to that area either. What could be wrong? [/INST] Doctor:Hello, A dent on the skull can happen due to osteoporotic changes in the bones. The dent on tibia can be related to shin splints. Direct examination will help in confirmation. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Praveen Tayal, 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 lump in thigh after an accident? Patient:hello, i had a fall about 3 weeks ago off my motor bike. i went to the hospital and had several xrays they have said no broken bones, the external bruising was very bad but faded away now but the lump on my right thigh is big and painful, should i ask for a second opinion or leave it a while longer??? [/INST] Doctor:Hello!Thank you for the query.This lump is most likely a blood collection in the soft tissues (hematoma). Due to some veins rupture and bleeding blood has appeared outside the blood vessels. Large hematoma wont go away by itself. Sooner or later it will become infected and turn into an abscess.That is why I suggest you to do not wait with it and consult a surgeon. Blood should be drained.Hope this will help.Regards. </s>

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

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest remedy for hair loss Patient:hello! this is sharmin. i've been suffering from severe hair loss since the last 2 years... and i am a patient of hypothyroidism. i am extremely tensed about my hair loss... its getting thinner day by day... what can i do to regrow hair? and to stop hair fall? and what vitamins do i need to take to regrow hair? [/INST] Doctor:Hello and welcome to HCM,You seem to be suffering from excessive hair fall commonly seen with hypothyroidism. Though your levels maybe normal , the overall hair growth and rate of growth may be affected more in your case,even on treatment.I hope your thyroid levels are in check. In your case, the hair fall ,maybe prolonged due to other factors as well, such as poor nutrition, stress, lack of rest, low iron and hemoglobin levels, hormonal changes etc. Dandruff,Chemical treatments,dyes on hair can also aggravate hair fall.For your hair to grow well, it needs sufficient nutrition.Fever, typhoid, recent illness, water change, work stress, pollution etc is a factor.Low hemoglobin/iron levels need to be checked as well.These causes need to be considered and treated as they affect hair growth.You can consult a dermatologist regarding any tests that may be required to diagnose the causes. They can assess your hair in person and advise accordingly. They may advise hemoglobin, iron, hormone levels if needed.For now you may start a Recute solution or Tress gro serum to scalp at night , along with hair supplements daily like Keraglo or Biotee capsule. This needs to be continued at least for 2-3 months to see results. Use mild shampoo and conditioner like Anaphase or Renocia for hair growthDo start with the treatment as advised and see a doctor. And remember to check your thyroid levels regularly as advised and follow treatment.Due to the thyroid condition, hair growth will be a little slower than normal.If your hair is very thin and scanty on the scalp, and medical methods do not work well for you,after a few months of observation, certain new surgical procedures can be considered such as PRP, as will be advised by your consulting doctor after observation, if they feel that it will be a good option for you. This is a later option.Also get a good nutritious diet, avoid stress,pollution, get good rest.Hope this guides you. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Q. I am concerned about discolored patches on hip. Kindly advise. Patient:Hello doctor, I am a 59-year-old female. I have discolored patches on my hip that just recently developed. Within the last month, I have had CT stomach, routine blood work, X-ray but they all returned normal. I do have chronic stress and I have been constantly losing weight and usually go to pass stool two sometimes three times a day. The stool is usually semisolid and there is frothy pale yellow liquid in it. I am not sure what is causing this discoloration, but I am really concerned. [/INST] Doctor:Hi. There are a number of causes of pigmentation, but you have not provided a picture to look that what type of pigmentation you are having. In my opinion, send a picture or see a doctor physically. Also, inform if other sites are also involved. Causes include drugs, diabetes, malignancies, idiopathic, post inflammatory, hepatitis, etc. For more information consult a dermatologist online --> </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Does intake of pineapples and papaya prevent pregnancy? Patient:Hi...im Alex from Malaysia here...I and my girlfriend having unprotected sex last night and I manage to withdraw in time but accidentally ejaculates a bit into her...she is now 3 week after her period last month...would she get pregnant? and I keep asking her to eat pineapples and papaya until the day she period, would it overcomes the chances of getting pregnant? thx. [/INST] Doctor:Hello dear,I understand your concern.In my opinion the prevention of pregnancy by eating of papaya or pineapples is a misnomer.There is no such thing in modern medicine.The first sign of pregnancy is missed period.Other symptoms of pregnancy like nausea,vomitings, increased urination,sore breasts start 2 weeks after missed period.As per your information a little bit of semen was ejaculated,so it cannot be definitely said that it will result in pregnancy.So I suggest you to wait and check for the period.If at all the period is delayed kindly do a urine pregnancy test a week after missed period for accurate results.So relax.Avoid stress.Nothing to worry.Kindly wait and check for the period.The papaya or pineapple increase the metabolism rate in body but there is no evidence that it will prevent pregnancy.Hope this helps.Best regards...,. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Should surgery be done for squamous cell carcinoma in Alzheimer s patient? Patient:HELLO, WE JUST FOUND OUT THAT OUR FATHER 90 YEARS OLD HAS SQUAMOUS CELL CARCINOMUS ON HIS BALD HEAD AND BEHIND HIS EAR. HE HAS ALZIMHERS (sp) AND VERY BAD BACK AND NECK PAI N CONSTANTLY. WE DO NOT KNOW WHAT TO DO AS FAR A OPERATING AT HIS STAGE .WHAT DO YOU SUGGEST/? THANK YOU LOVEING DAUGHTER MARIANNE [/INST] Doctor:Age and Alzheimers are no contraindications for treatment of squamous cell carcinoma skin. if the lesion is small it safely be excised. If extensive then you need to sit and discuss with your treating doctor, whether to go ahead or not. but best option would be to treat when there is chance of cure </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Elevated GGT levels. Taking omeprazole. What to do? Patient:Dear Dr my GGT level is 169 currently it was 120, 6 months back, Besides this I have raised SGPT =60 and my ANA test is positive. I am social drinker(usually what do you advise me?Shirka , from Ethiopia [/INST] Doctor:Hi friend, Welcome to Health Care Magic Positive ANA test demands further investigation for auto-immune disease. Impaired liver enzymes could be a part of that picture... Hepatic viruses have to be investigated - qualitative first, if necessary, quantitative estimation. Alcohol should be stopped - immediately, completely and permanently At times. liver biopsy may be necessary Discuss with your Hepatologist... Take care Wishing speedy recovery God bless Good luck </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Q. My mom feels dizzy and weak with diabetes medicine. What to do? Patient:Hi doctor, My mother is 53 years old. She is a diabetic and under medication. Her list of medications is as follows: For diabetes, Glyciphage SR 1 gm (1-0-1) and Volibo 0.2 (0-1-0). For cholesterol, Stator 10 (0-0-1) and for stamina, Stamina-OD (1-0-0). Under medication, her sugar levels before food and after food are 103 to 160 and 190 to 200 respectively. While not having the medicine, the level is 210 before food. The issue now is with the medicine. Whenever she takes the diabetes medicine, she is getting tired, feeling dizzy with overall mental and physical weakness and literally wants to be on bed. At times, she is frustrated as well. Please advice what we should do. [/INST] Doctor:Hi. For further classification consult a diabetologist online --> </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Child suffering from morning coughs. Suspecting asthma given clenil & ventolin. Other suspected allergy gave gave ceretide and rigix. Asthma or allergy? Patient:dr. Sb I read ur MSG. Thank u soo much but I am really concerned. Actually he has these symptoms for past one year.. Now he only has bouts Imogen cough in the morning. No wheezing as such. Is it asthama or simple allergy I don't know. His father also has it . Once he gets up in the morning he coughs and takes it out then fine.my son also coughs so much that its difficult to send him to school in the morning. When he cums back he is fine. In the evening when I take him to doctors they say is chest is clear. Don't know what to do for the morning cough... Any reply in this regard will be really helpful.Just mentioning it here that one doctor said its step 3 asthama and gave clenil and ventolin inhaler 6 month program. The other said that its childhood allergy and gave ceretide and rigix for a month and follow up. Which one should I follow. Gave him ventolin puffs last night and clenil for the first time and he was better in the morning . Gave puffs again in the morning. But now read on clenil inhaler that not suitable for children. So got confused can I stop this treatment abruptly if its too heavy and not needed.And also is zatofen better or the above mentioned inhalers for a long term use [/INST] Doctor:Hello dear,The symptoms as mentioned in your post suggest that your son might be having Allergic bronchitis.Clenil & ventolin helps in dilatation of respiratory passages & reduces the inflammation.Zatofen also provides relief but through a different mechanism.The decision to use these medications should be taken only after a clinical examination.Other than that:1. Maintain adequate hydration & a healthy balance diet.2. Also make sure that your child is well protected from cold, dust & other allergens.Wishing him a good health.Take care. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What to do husband is addicted to Corex for mental stress? Patient:I got married 3 years back. My husband is addicted to corex. I have a 2 yr old child. My husband is suffering a downfall in business. Due to this we have lots of tensions. I have never seen him drinking corex. But found the bottles in home. He says its because of tension. He says he drinks only half a bottle that too not daily. I don't know the truth. Plz help. How can I help him to get rid of this habit. I am very much worried. [/INST] Doctor:There are two things there stress/depression and secondary addiction of corex. Corex contain codein a type of opioid which cause severe dependence and difficult to quit.When person in stress and if he gets opioid he feels relax and forget his problems for a while.As time passes he will need more amount to get the same relaxing effect.So make him explain that he is on the wrong way.He is wasting money in corex and adding loss to his business downfall. Make appointment with psychiatrist-deaddiction specialist who can surely help you and your husband to come out of this. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes paleness while sleeping? Patient:My two month old son was put on a new formula (similac alimentum) with rice to thicken it over a week ago by his ped. Since then all he does is sleep and i can t seem to keep him awake. I also noticed he s pale when he s sleeping. What could be causing this? Could it be the formula? [/INST] Doctor:Thanks for posting your query at HealthCareMagic. Ideally (as per American Academy of Pediatrics as well as World Health Organisation) a two month old baby should be exclusively breast fed for 6 months after which weaning with semi solid food like mashed boiled food or cereal based formula is done. I would not recommend introduction of rice at this age though many baby food companies market their "stage 1" foods to children between 4 and 6 months old with the precaution that the food is meant to be consumed in addition to breast milk or formula. So, try switching back to breast milk if adequate amount can be procured. In case of an working mother, breast milk can be expressed and stored in a refrigerator. If not, formula feeds including similac alimentum may be given. It is hypoallergenic. I do not know if your baby has milk allergy or a similar condition due to which the pediatrician asked him to take such a formula in addition to rice. It is not likely to cause paleness during sleep. The paleness can be evaluated by checking the hemoglobin content of blood.Hope that would resolve your queries. Feel free to revert back in case of any further queries. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What diet should I follow after the operation of gall bladder? Patient:I'm an Indian (West Bengal), 60 years of age, Male, ht-5' 11'', wt- 72 kgs. On 9/5/2011 Blood Suger detected- 147 (F) and through x-ray osteoarthritis (Knee). In the last June,2010 gallbladder operated. Pl suggest me exactly what to do including diet for throughout the day in writing. [/INST] Doctor:Hello and thanks you for your query. I am Dr. Rommstein and I will try to help you as much as I can with my answer.There is no precise diet,but generally you should avoid fried food,alcohol,fats and high sugar food,carbonated drinks and smoking. I hope I have answered you query. If you have any further questions you can contact us.Kindly regards. Wish you a good health. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes upper abdominal pain and knot in pain area? Patient:About a week ago I started having pain in my upper abdominal area. It is a fairly small spot that the pain is concentrated on. Almost feels like a knot like you would get in your back, except I get a sharp almost tearing feeling when I laugh, or cough. Should I be worried? [/INST] Doctor:Hi.Yes, you should be worried. This can be a small hernia as per history you have provided. Get this checked by a Surgeon. You may need ultrasonography to confirm.If this is a hernia, get operated. as this may cause complications if not treated. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: How serious is flora klebsiella oxytoca and psedomonas fluourescens? Patient:From a culture I have a report of having flora klebsiella oxytoca and pseudomonas flourescens . Should I be hospitalized for this. I have been given Augementin 2 tabs a day for 14 dauys. Is this sufficient to cure thi. How dangerous is it? Anna Howell [/INST] Doctor:Hello, Thank you for your contact to health care magic. I understand your concern. If I am your doctor I suggest you that the antibiotic is sufficient for cure of your infection. Both this organisms Klebsiella oxytaca and Pseudomonas fluroscence are highly resistant organism for routine antibiotics. I think your doctor has given you a drug which is sensitive to this organisms so do not worry take complete course of the drug.I will be happy to answer your further concernYou can contact me. Dr Arun Tank. Infectious disease specialist. Thank you. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Q. I get recurrent unbearable pain in ears with hearing capacity of only 15%. Please help. Patient:Hello doctor, For the past three days, I am having unbearable pain in my right ear. I doubt somehow in the meantime of bath some water must have gone through it. And by my right ear, I could not able to hear anything. My right ear hearing capacity is 10-15% and it is closed. I have faced this issue twice already. Please help. [/INST] Doctor:Hi. There are three possibilities for your problem. First is, impacted wax can be there which can create lots of pain, ear fullness, and decreased hearing. You can use Soliwax drops three drops thrice daily for five days. Second possibility is a fungal infection which usually presents with ear fullness, itching, and pain. If there is no itching and mild discharge then there is very less likely to have a fungal infection. Third possibility is a eustachian tube catarrh wherein the pain is not as much, but your main symptom will ear fullness, decreased hearing, feeling of water inside your ear, history of recent upper respiratory infection, or history of previous allergic symptoms and there is usually no itching associated here. You can take a tablet containing Paracetamol, Levocetirizine, and Phenylephrine combination whichever is available in your country. One tablet twice daily for five days. If the ear fullness does not come down, you have to get your ears cleaned by an ent specialist. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What does chronic micro vascular ischemia with empty sella signify? Patient:MRI the comments is; no intracranial lesion found to account for the clinical symptoms and signs, no lesion of the optic chiasm is seen. There are periventricular white matter changes which are most likely to reflect chronic micro vascular ischaemia. Incidental empty sella. Could you tell me what the mean for me. Thank you. Carmen [/INST] Doctor:Hi ,chronic micro vascular ischemia is age related changes and carries no significance. Empty sella is also incidental finding.If not causing any symptoms then nothing to worry ,Thanks. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest treatment for breathing difficulty with stomach pain and nausea Patient:I have started having panic attacks and when I have them, it s hard to breathe. I have always been a constant worrier and have always been stressed. I get knots in my stomach that make me miserable and nauseated badly. sometimes I throw up. I can t eat like this and I lay awake most nights when this happens until 3:00 to 4:00 am. I do this at least once a week and this whole mess of problems may last up to 4 days and sometimes longer. I have gone to several physicians asking for help because I make the mistake of asking for Xanax. I took that medicine for several years and it took the problem away, then the doctor who prescribed them retired. I don t know where to turn. I had it so bad the other day, that the knots in my stomach were real high up in my stomach (right where I hurt when I had a gallbladder), but when my stomach was like that it felt like my throat was swelling shut or it had a big knot in it one. My mom gave me a Xanax and after it started working, my stomach settled down and my throat wasn t swollen any more. that was the only relief I had for 3 days of living with my stomach and throat like it was. I am 60 years old, and I m not trying to get a buzz like I have heard some younger people do, I just need one for my nerves, not to abuse, just for relief. When I had them prescribed before, the doctor gave me too many, I thought because he gave me enough to take 6 per day. I can truthfully say, if I took one it was usually one about mid-day and one at bed time. If my stomach wasn t bothering me, I took one only when I was nervous and got the shakes real bad, or at bedtime if I couldn t sleep. Why is it so hard for someone to get a prescription when they need one, that s what they are manufactured for. [/INST] Doctor:Hi.hanks for your query and an elucidate history. After reading and re-reading your history I could get is that you need Xanax. You should consult another Doctor For a second opinion and any good Doctor would certainly after going through your history would prescribe you this . As a precaution due to your age of 60 , you should get yourself investigated at least once and I would advise you the following:Investigations:*Routine blood investigations like Complete blood picture, blood sugar, urea, creatinine, liver function tests, thyroid function tests.*Urine -routine and microscopy*Stool: routine, microscopy, occult blood, culture and sensitivity.*Ultrasonography of abdomen,*Colonoscopy All these investigations should be within normal limits for one to say you have IBS.Treatment:''STRESS'' = stress is the most important cause of IBS. Please remember and you must have observed that when you do not have stress your problem with IBS is reducedChange of lifestyle.I think 'may be' you are not coping with something. Vacation outside of your area, mobiles phones to be off.You must have noticed already that these changes help a lot. Try to avoid anything which you are / have to do against your will and wish. Getr into the hobbies which make you forget the world around you. Life comes only once, </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What does dotted eruption on glans penis mean? Patient:i am 30 yr old married and have a 3yr old son. i am having small dotted erruption on glans penis for last 8 months. tested negative for HIV and VDRL. the glans looks red and inflamed but all disappears on its own to again recur. No discharge per urethra. have tried antifungal and doxycycline. no sexual dysfunction but bothering. sometimes itching. [/INST] Doctor:Hello, This might be due to allergic reactions to clothes, latex-containing condoms or some drugs if you are using. However, infections other than STIs could be a possibility as well. I suggest you to take precautions like keep it clean, dont wear tight clothes or apply petroleum jelly over the lesions. If not settling I suggest you to see your doctor for a checkup. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr SAMEEN BIN NAEEM, 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 swelling on both sides of neck? Patient:Hi..I have swelling on both sides of my neck above the collarbone. Saw m.d. yesterday and he is setting up ultrasound but did not feel nodes. He said it felt more like soft tissue. Appears to me this a.m. to have gone down some. Everything i have read online points to cancer. Should i be worried? I am 37y.o.female with no chronic medical problems. [/INST] Doctor:Hi.. Thanks for using Health care magic. If there is visible swelling in your neck and is supposed to be a soft tissue swelling I suggest you to do FNAC ( Fine Needle Aspiration Cytology) or an incisional biopsy of the swelling as soon as possible to know the origin of the swelling and then you can proceed further confidently.Hope it's only a benign swelling. Take care. Thank you. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: How can a lump in the groin area be treated? Patient:My 16 year old daughter has a small lump down where her leg and private parts are and her hair is falling out like crazy! She saw a doctor last week and said it just looked to be a glad or something and to put warm compresses on it. It has gotten a little bit bigger (from pea size to marble size). The has severe skin issues so has been on topical steroids for the past few months. Could these symptoms be from that or should we be concerned it is something else? [/INST] Doctor:Hello and Welcome to ‘Ask A Doctor’ service.I have reviewed your query and here is my advice.Is it painful one side or both groins? You mentioned skin lesions and using steroid cream. The skin lesions probably infected and she developed lymph node enlargement in the groin.Treat the infection with the antibiotic if the skin condition looks infected. Consult the local doctor.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Vinayachandran PK </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes blood in the urine and high blood pressure? Patient:IM A 37 YEAR OLD MAN AND I DONT HAVE INSURANCE OR A DOCTOR..RECENTLY I WENT TO a e.r. for tooth pain and my blood pressure was191 over 121...and i have noticed severe ankle swelling around my socks at end of the day...and i just went to the bathroom and it looked like i was shot in the but...blood ..lots of bright red blood...im scared im dying? [/INST] Doctor:Hello, After going through your medical query I understand your concern and I would like to tell you that high blood pressure with ankle swelling is most likely due to cardiac disease which requires proper evaluation. It's recommended for you to get basic cardiac evaluation done which includes ECG and Echocardiograpy and consult a Cardiologist with reports. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Bhanu Partap, Cardiologist </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What to for nodule in the lung? Patient:I have a nodule on my lung which the pulmonologist thinks is due to the bronchial infection I had, but will follow up with another cat scan at the end of the month. I was given antibiotics which helped but my chest is still clogged especially in the morning and the evenings, afternoons are fine. I also feel that I have have nasal drip which is causing the chest congestion. The humidifier has helped a lot with nasal congestion, plus I took claritin which helped. I am still on Advair, and also was given Ventolin inhaler, which I have used at least 2 timews to 3 times a day. Please help [/INST] Doctor:Hello dearWarm welcome to Healthcaremagic.comI have evaluated your query thoroughly .* This is in definite relation with the underlying respiratory infection which can be bronchitis or else .* Once the basic pathology is controlled precisely , then it gets resolution with time .Hope this clears your doubt .Wishing you fine recovery .Welcome for any further assistance .Regards dear take care . </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: 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: How much fluid should be given to an infant while teething? Patient:HI I have a 6 month old who is teething. He has started refusing his milk in the last couple of days but will have food and water. Just wondered how much fluid he requires a day so i can monitor it. He is probably having just under 6 wet nappies a day at the moment but seems ok in himself other than the obvious teething [/INST] Doctor:Hello, There is no specific requirement at this age group and you can give on-demand fluids. But age-appropriately you may give the baby 600 to 700 ml of total fluid per day at this age group if you are not giving any milk. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Sumanth Amperayani, Pediatrician, Pulmonology </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What is the treatment for high cholesterol? Patient:Hi, i am female aged 50 yrs. i had heart attack 4 years ago which resulted in as stent. have been quite well since however suffer from high cholesterol regardless of good diet. several statins have given me bad side effects. which is the best and gives less side effects. [/INST] Doctor:Hello, The benefit of statin post angioplasty is established without doubt and should be offered to all patients. Of all the statin rosuvastatin in minimum dose and maybe alternate days may be considered if muscle ache was the main side effect . If liver enzymes were raised significantly at any time , avoid all statin . Regards Dr. Priyank Mody </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: How can depression along with anxiety and insomnia be treated? Patient:I am struggling with depression that got worse after open heart surgery and an emergency bowel surgery 6 days later to save my life. I am seeing psychiatrist and taking meds to help with anxiety and sleep disorder. At my appointment Friday my doctor to me she could not help me since efforts have not improved me. What do I do now that she has told my physical condition is all in my head. [/INST] Doctor:HelloCan you please give the details of medications which you are taking?In general, I would suggest you to practice relaxation exercises like deep breathing and meditation.Hope to hear from you soon.Thanks </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest treatment to reduce knee pain Patient:I think that I may have torn my medial lateral ligament on my L leg. I was surfing and the knee clicked when it twisted a little when I fell from the board. It hurt (but not too bad). I walked half a km home carrying the board with mild pain. I iced the inner part of the knee 3 times, went to bed and had to have pain control after 5 hours. I can not twist the knee at all now without severe pain, but I can walk without twisting. Should I go to the doctor and get an MRI? Can it wait until Monday? Should I strap it until then ? Cheers, Bill [/INST] Doctor:Hi, BillYes, you need the MRI to fully assess the damage hereIt can wait until Monday and for now, rest, heat, and a strap will do </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Is it safe for cancer patient to undergo angiography and angioplasty? Patient:hi...i am somak from mumbai... my father has been suggested to undergo angiography and angioplasty while his treatment for NHL. i have the following queries 1. how costly is the procedure in totality? 2. is it safe for a cancer patient to undergo this procedure?? [/INST] Doctor:Hello, I don't know how much it can cost but I can say that this procedure may be lifesaving for your father (I mean for the heart problems). Angiography and angioplasty are not contraindicated in cancer patients. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Anila Skenderi, 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 can pain in the lower back be treated? Patient:I have a 19 yr old son that has scoliosis and recently playing a basket ball game he bent down and another kid landed directly on his lower back it s been 4 days and hes still hurting when he twists, bends ,or turns a certain way. He has had his gall bladder,& appendix removed. He has broken his left ankle once on each side the first time he shattered the bone the second was a smooth break he also used to take 21 mg concerta for his ADHD but has gotten himself off the medication, my question is should I worry about this maybe being an illness as to injury and what do u recommend we do about his back he s in pain mostly in the evenings [/INST] Doctor:Hello and Welcome to ‘Ask A Doctor’ service.I have reviewed your query and here is my advice.In my opinion, it would be advisable to visit a doctor and get an X-ray done. If the pain is severe then this can mean a fracture and an X-ray would rule it out.Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Fahim Sheik </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest treatment for fever and cough Patient:Hi, I'm a 27 year old man and early this morning, after only a few hours of sleep, I suddenly woke up feeling unable to breath properly, as if something was blocking my throat. In an effort to breathe I was doing this weird cough-like function, like 10 times, which didn't change the situation. I felt that only minimal or no air at all was allowed in. I had a bottle of water near me so I drank some and after that I was able to breathe better, though I don't know if that's what helped me. However I was somewhat scared since this has never happened to me before, so I went to the ER.There, the doctor did a few basic tests, heard my breathing, checked my throat, took my blood pressure and a blood sample for blood tests, mostly to see the oxygen levels, as well as a chest area x-ray, and asked me the usual questions, like if I've been sick and taking any medication, which are both negative. He also asked me if I felt anything weird still and I said my throat was sore though it may have been just because of the effort it took to breathe earlier.The doctor found everything normal, my blood pressure was surprisingly good too since I usually have a little bit hypertension, so he sent me home and I was frankly relieved, though I didn't feel like going back to sleep, in the end I fell asleep. It has now been 5 hours since the incident, and my throat still feels sore and weird, perhaps more so than previously, so I'm worried the episode will happen again.Other information the doctor asked me, in case you need it too, is if I smoke, which I don't personally though I live with chain smokers so the house is often full of smoke, if I have any known allergies, which I don't, to my knowledge, as I only remember having an episode like 10 years ago but we never figured out what it was that I reacted badly to, with rashes and itch all over my body at the time, and it has never happened since. Anyway, I also feel like I may be coming down with a fever now, though the doctor took my temperature as well and while I didn't ask how it was he didn't mention anything about it.So, what could this be, waking up unable to breathe, and still feeling sore after 5 hours despite the ER doctor finding everythingi n order? [/INST] Doctor:I have read all your question in detail first I would like to ask you* do you have snoring?* frequent Nasal stuffiness/blockade ?I want to know this also because sudden awakening from sleep and feeling of sob may be due to sleep apnoea as well .and of course your home environment (chain smokers) is also not good.and sore throat with fever may be due to viral or bacterial infectionso you can take some broad spectrum antibiotics, take hot fluids and I would suggest saline gargles as wellI hope my answer will give you satisfactiongood luck </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Q. I am suffering from pain in lower abdomen, penis and testicles. Kindly advice. Patient:Hello doctor, I have pain in lower abdomen, penis, and testicles. Please advice. [/INST] Doctor:Hello. Pain in lower abdomen and testes can be due to multiple causes ranging from urinary tract infection, infection of testes, varicocele, or some stone problem in ureter and kidney. You will need a few investigations to see for the cause then only treatment can be advised. You will require sonography of abdomen and testes, microscopic urine test, and renal function test. Depending on the report of this test, we can determine the cause and advice further. If pain is too severe, you can visit a urologist for physical examination. Sonography of abdomen, pelvis and scrotum,with colour Doppler testes, urine microscopic test, and renal function test. Epididymo Orchitis, urinary tract infection, varicocele, and intermittent torsion. Follow-up with reports. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Q. Swelling, pain and enlarged veins in testicles. What could it be? Patient:Hello, I am 16 years old. I have been having discomfort in my testicles since 3 years. I was then examined by the doctor and he found some swelling in the left testicle and there were also enlarged veins. There were no hard lumps on examination. I then had a scrotum ultrasound that revealed 5 calcium deposits in the left testicle. On my paperwork it says, diagnosis- testicle pain- varicose and hydrocele? What does this mean? [/INST] Doctor:Hi,  Welcome to icliniq.com. Consult a urologist online to know the progress of the condition and the need for surgery --> </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Will edogest 100 help in getting pregnant and when is my ovulation date? Patient:Hello .. My age is 25 last month my periods got delayed for 7 days ... this month i want to conceive as my hubby came aftr a long time from UK . i really want to conceive coming month . my cycle is 33 to 34 days evry month .wen is d fertility date?? . i got my periods on 28 april .. i m having Edogest 100 since 5th May . will it help me to conceive dis month .?? or shud i consume some more tablets after d course of 15 tablets ?? [/INST] Doctor:hello,Your fertile days will be between 16th to 24th of each regular cycle. Ovulation occurs 14 days prior to next due date. You can use ovulation prediction kit.Yes, Endogest 100 will be helpful to get regular period with proper ovulation which enhances chance of your pregnancy. Take folic acid supplement for 3 months. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest treatment for neck pain in a diabetic Patient:My mother is 89 years old. She has high blood pressure, but control with medication. For the past few days she s been feeling pain on the left side neck vein. She holds the neck sometimes and tell us is relief. Please help! I want to take her to the doctor soon as possible. She never wants to go to the doctor. Please tell me what you think this is. Thank you! [/INST] Doctor:Thank-you user for your query.I understand your concern.In your case one cause of neck pain towards left side may be due to hypertension.But as per your history its clear that it's controlled with drugs.Start giving her calcium as her age is such that osteoporosis happens more likely.Kindly ask if she is having pain radiation in her left arm also or is it localized to neck area only. This may be cervical spondylitis also and for this you may get an X-ray done but kindly get this condition ruled out by any orthopaedician. Get an Ecg and 2D echi done under supervision of any cardiologist.For pain you can give her ibugesic and neurobion forte also.She will be all right soon.god bless </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Q. I have pain, irritation, and dryness of eyes. Please help me out. Patient:Hi doctor, I am a student, and I stay in a highly polluted area. I got shifted here five months ago. Early in the morning as soon as I wake up for five to ten minutes, my eyes start paining and irritating. Few times it also turns red. Due to this I could not wake up on time and also feel uncomfortable. When I study I feel some dryness in my eyes. Please help me out with some suggestion. [/INST] Doctor:Hi. By your description, it looks like a condition called vernal keratoconjunctivitis. It is a type of allergic condition. It increases in summer and dusty polluted environment. I suggest you wash your eyes with cold filter water twice a day. Also, use Pataday eye drops (Olopatadine hydrochloride ophthalmic solution) twice a day regularly for as long as you have symptoms. When itching is severe you can use Moxigram LX (combination of Moxifloxacin and Loteprednol etabonate) eye drops 2 hourly or as frequently as itching occurs. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes numbness in left leg with sacralisation of l5 vertebra? Patient:hi.. I have numbness in left leg toe and numbness in left leg and left hand. I have MRI 1.transitonal vertebra with sacralisation of l5 vertabra. 2.modic type-II end plate changes l4-l5. 3.l4-l5 diffuse disc bulge indenting thecal sac. 4.changes of lumbar spondylosis. [/INST] Doctor:Hi, I am Dr.Bruno. I have read your question and understand your concerns. Let me try to help you Question : What causes numbness in left leg with sacralisation of l5 vertebra?Answer : Two Possibilities 1. The Diffuse Disc Bulge in probably compressing the nerve root in that area and this causes numbess in Left Leg .2. You also have numbness in Left Hand. So This can be due to some generalized problem like Diabetic Neuropathy. Please get your sugar levels checked at the earliest Hope you found the answer helpful.If you need any clarification / have doubts / have additional questions / have follow up questions, then please do not hesitate in asking again. I will be happy to answer your questions.Let me know if I can assist you further.Take care. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Took next choice after unprotected sex. Bleeding, white sticky discharge after taking pill. Cause? Patient:I had unprotected sex 2 days after my period ... took Next Choice 9 hours after. 6 days afyer taking the pill I had a period like bleeding (this happened while I was supposed to be ovulating) after the bleeding went away I've experienced some discharge that's white and sticky. What's the cause of that should I be worried? [/INST] Doctor:Hi dear,The fact that you have taken pill 9 hours after and had bleeding like normal period, makes you quite safe from pregnancy. However, these are hormonal preparations and do leave some side effects in body. The discharge which you are experiencing, if not associated with foul smell or itching may be normal and nothing to worry about. In presence of any associated symptom, consult a gynae for the treatment </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Taking an OTC med, felt like affecting cognitive abilities, stopped it, getting itching, upset stomach, ear ache, eye itching. Patient:I was taking an OTC med but it seemed to be affecting my cognitive abilities a great deal. I have been off the med for about 2 weeks and my allergies are killing: itching, upset stomach, (comes and goes), ear ache/itching and eyes itching. I know that I m allergic to dust and I do have my mattress encased in an allergy cover. [/INST] Doctor:Hi,Thanks for using Healthcaremagic,You are having allergic problem with dust in the form of itching and Rhinitis.Yes taking anti allergy medication can affect your cognitive abilities.Please consult physician and take proper allergy tests like your IgE level and even in vitro allergy test can be done.There are relatively non sedating anti allergy medication which can help and even if it necessary to use short term oral steroids can be given by your doctor.This is good that you are taking precaution and avoiding dust this should help you.In dust hose mite is there if allergy is specific it can be treated with immunotherapy.Hope this helps.Take care.Good Luck.Dr.Akhilesh Dubey M.D </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Is cypon syrup taken for general weakness? Patient:hello sir, i just want to know.... that what in actually the cypon syrup do.... coz m taking it for the general weakness purposes.... as m very much thin... my face also looks very weak.... so i just want to know, that whether cypon syrup can help me for gaining my weight nd can makes me healthy? [/INST] Doctor:Hello, Tricholine citrate increases hepatobiliary flow that results in greater availability of bile in GI tract. It also increases emulsification, transport and utilization of fat. The combination of Cyproheptadine and Tricholine Citrate help increases appetite due to its synergistic effect. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr AJEET SINGH, 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 squeezing pain in chest, dizziness, and numbness? Patient:i felt like my heart shrunk for a second, like someone squeezing it. Then i get a numb feeling in my head, its like the feeling before fainting. Then i start feeling dizzy and breathing difficulty. But it all happens in a few seconds. I first had it two or three months back while i was having dinner. Since then it became more common and has happened a few more times. I would like to know what are the possible causes because its kinda worrying. I m worried that it would get even worse. Thanks. [/INST] Doctor:hello, There are two possibilities, one is gastritis and reflux disease and second is cardiac arrhythmia. It can be a acidity and reflux disease. Do you upper abdominal pain, nausea, bloating, burping, increase in pain on food, sour water feeling in throat or chest burning, if yes it further supports the diagnosis. You should avoid fatty, oily and high calorie diet. Have some walk after having food instead of taking rest. Have multiple small meals instead of heavy meals. Have regular sleep habits and avoid stress. Lots of green leafy vegetables, fruits. Avoid smoking and alcohol if any. You can get prescribed tab Pan DSR 40 mg beforebreakfast once a day for 2 weeks. If none of the above symptoms are present, then there is a possibility of cardiac arrhythmia like psvt or atrial fibrillation, in which heart rate suddenly goes up and also suddenly decreases. Blood pressure falls during these episodes and one has dizziness, fainting, blackouts, sometimes syncope. Usually ecg is normal as it is usually done in between the episodes. ECG done during episodes will show abnormality. You will need 24 hour holter monitoring. So visit nearby cardiologist for these investigation. ln order to abort such episodes you should try to cough hard. Till the time your evaluation is complete, you can ask your local doctor for tab ciplar LA 20 mg once a day. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Q. How many days will it take to dissolve kidney stones with medications? Patient:Hello doctor, My wife is having 12 mm, 10 mm stones in both left and right kidneys. Currently, she is using Cystone forte, Neeri tablet, and Smashit. So, how many days it will take to dissolve these stones? [/INST] Doctor:Hello. I just read your query. See first of all let me tell you one thing that the size of the stones is large. Kidney stone having size around 4 to 5 mm get dissolved with the help of medicine easily as compared to large-sized stones. Another thing is the composition of stone means from which thing the stone has been formed, that also matter. Some stones are unable to dissolve with the help of medicine. But we cannot know without examination from which thing the stone has been made. So continue your treatment. In case you face any trouble you may require consultation from a urologist. If stones will be dissolved with the help of medicine then fine otherwise she might require surgical management. Genetic cause or poor eating habits or some underlying disease. USG abdomen. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest treatment for painful rash on the fold of inner thigh Patient:I have a very sore and painful rash on the fold of my inner thigh near my vagina. I've tried hydrocortisone cream but it burns and it is very unbearable. When I shower and water gets on it It's very sore and very painful. What can I put on what I think is a fungal Infection to ease the pain and help it heal? [/INST] Doctor:Hello,I read carefully your query and understand your concern. The symptoms seem to be related to a fungal infection. I suggest using Clotrimazole cream for local application. I also suggest using Diflucan for three days.Hope my answer was helpful.If you have further queries feel free to contact me again.Kind regards! Dr.Dorina Gurabardhi 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 are the precautions to be taken during a pregnancy? Patient:Dear sir, I am working woman and presently 5 weeks preganant after two miscarriges.Today i have gone some place for some work but because of heavy rain, roads are not smooth and there were so much bumping while travelling by car. I m tense whearter my baby is fine or not.What precautions i have to take during the pregnancy? [/INST] Doctor:Hi I am aware of your concern and happy to guide you through this. During your pregnancy first of all you need to take care of your diet, don't take much stress, have a proper sleep, little of exercise but not too much of work load. If possible you should reduce travel for your work purpose and don't take stress </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest remedy for mucus in stool Patient:my baby is almost six months old by this january 4, these past days, she began to get slimy stools and i got stool test for her and it came out that she had amoeba, then the pediatrician prescribed methanidazole for her,after taking 6 ml, she began to get swollen gums and she was crying and didn t want to drink milk. i bought her to see another doctor and got her stool examined again and found out that she didn t have amoeba but she had bacteria because there was mucus in her stool, the doctor prescribed chloramphenicol and she took 7 ml already out of the 28 ml that she must take. and the doctor asked me to reduce the scoop of formula milk. now, the stool always comes out every time she farts and the stools that come out are just in small quantity and the stool is still the same, still have mucus. what is wrong with my baby, should i continue the chloramphenicol palmitate. please help me [/INST] Doctor:Hi, Please be informed that amoebic cysts are common in the stool routine and it needs treatment only if there are trophozoites in the stool routine. Treating it with metronidazole might have induced antibiotic-associated diarrhoea and I suggest you stop all antibiotics and give only Saccharomyces boulardii probiotic. 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: Should a liver biopsy be done for elevated liver enzymes and fatty liver? Patient:I am a 63 yr old woman. My doctor has been checking my LFT s for a few months since only my ALT went up to 43 after two months of taking more tylenol then I usually take but not even considered a lot. After staying off Tylenol and alcohol for 3 wks, we retested and my ALT was down to 40 but she recommended a liver ultrasound. Results today show mild fatty liver. I am normal BMI and all other testing on blood for other causes is negative. All of my blood tests were normal in Feb, 2018. I also take 4mg of Testoterone daily and Fosomax 70mg once a week. Have started Fosomax in March, 2018, Testosterone taking for over a year. Should I have a liver biopsy considering there is not a logical reason for a fatty liver? I usually drink 7 drinks a week but am willing to cut back or stop. My doc wants to recheck blood in three months and said I can drink my 7 drinks a week. Thoughts? [/INST] Doctor:Hi, I don't think that biopsy is required. it would be better to do MRI Scan. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Iven Romic Rommstein, General Surgeon </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: how can I overcome the habit of laughing for no reason ? Patient:sir i am facing problem of for nothing laughing plz help me [/INST] Doctor:hi well come to Hcm. Better consult psychiatrist.He will guide you better laughing withot reason may be asssociated with some psychiatric aliment. Thanks </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: How can sciatic pain in the lower back be treated? Patient:m\My husban is in severe pain. It s sciatic nerve because its on both sides and lower back. He s caramping real bad. I know he has to keep miving because he have trouble just standing. He s taking a muscle relaxer and tyelonol gels 500mg for pain. Is there any thing else we can do to get him feeling better. [/INST] Doctor:Dear patient pain in back and both lower limbs may be due to nerve compression in the Lower lumbar area.Reason may be disc degeneration or hypertrophy of ligamentum flavam. Diagnosis needs to be confirmed by doing MRI of the lumbo sacral spine. Please get it done from radiology centre nearby you. Meanwhile start tab pregalin x 75 mg one at bedtime with tab Dan MR twice a day. Rest is absolutely needed and alone drugs cannot work. So take proper rest for at least 3 to 4 days. If not relieved within a week please consult spine surgeon nearby you. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What are the adverse effects of Proair HFA aerosol? Patient:Hello, our 14 year old daughter has been diagnosed with asthma at the age of 4 and allergies to animal dander mostly. Since then she has used Pilmicort, Proair (both via canister and nebulizer) Singular, Q-Var and most recently FloVent in the am and pm. However, on a daily basis, she reaches for her Proair before P.E., after running, laughing, sometimes in am and sometimes before bed. Her pediatrician has recommended a pulmonary specialist for us to see in hope that she can get control and not have to use the Proair so often throughout the week. Naturally, the hope is that these years of administering Proair so often has not and will not cause any issues in the future as she grows. What say you? [/INST] Doctor:Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. Proair is having Albuterol. It is short acting beta 2 agonist (SABA). All inhalers are very safe in long term use. Inhaled drugs reach directly to the lungs without affecting any other organs. So no systemic side effects with inhaled treatment. So no need to worry for long term side effects of Proair or other inhalers. Hope I have solved your query. I will be happy to help you further. Wishing good health to your daughter. Thanks. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: How can asymmetric to the left superimposed uncovertebral disease be treated? Patient:I had an MRI of my cervical spine done last Friday. Part of the report states that at C4/C5, irregular degenerative ventral disc/osetophyte complex notes asymmetric to the left superimposed uncovertebral disease. Partially effaces the ventral subarachnoid space. The only thing I understand is the part about the bone spurs and that uncovertebral refers to C3-C7 [/INST] Doctor:Hi, In between the vertebra (bones in the back), there are discs. Degeneration of the vertebra usually implies that there is arthritis of back. Osteophytes occur in arthritis. The spinal subarachnoid space is space in the spine which contains CSF. The imaging suggests that it is mildly affected. You should consider speaking to your neurologist or orthopaedic surgeon. 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: Is rifampicin tablet good for transverse tarsal joint of foot? Patient:is Rifampicin tablet is good for transverse tarsal joint of foot ??? IN my foot at transverse tarsal joint have little facteur . it had came 3 weeks ago . what would you suggest me ..!! I want only best tablets to do it quickly heal . which be available in india . [/INST] Doctor:Hello and welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. There is no pill by which fracture will get heal soon. Lower limb fracture takes one month to one and half month to heal if treated conservatively. For faster healing operation has to be performed (open reduction and internal fixation). Only certain factors like calcium intake, taking rest helps in proper healing of fracture. Rifampicin is a drug which is used to treat tuberculosis not fracture. You may do weight bearing exercises once your fracture heals for better strength of healed part and early return to your active life.Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Harsh Swarup </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes recurring numbness in hands, feet and knee swelling? Patient:I am 21 year old female, 5 10, maybe 155lbs. I have noticed slight numbness in hands and feet that comes and goes, and just noticed swelling behind my knees it is not painful. In addition my arms and feet have become more prone to totally falling asleep. Medical history includes heart problems- I also just moved to china where it is difficult to eat well. [/INST] Doctor:Hi, I think you should get your spo2 checked in both upper and lower limb very week. If it is below 90% you should consult vascular surgeon. Because if there is decrease in blood flow it may cause numbness in hand and feet. You have not mentioned about parasthesia and pain. If you have that than should met MRI spine and vitamin B12 level check. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Gaurang B. Shah, Orthopedic Surgeon </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Does reducing weight increase penis size? Patient:Hi, i am 22 yr and i am slightly obese my main concern is abt my penis size. When its flaccid only the glans or the head is visible and when erect its abt 3 and the shaft is really slim. Should i consult a doctor physically. Will reducing weight increase my size? [/INST] Doctor:Hi,There is no change in penis size after loosing your weight but after loosing your abdominal fat there will be apparently penis size will look bigger as due to abdominal fat penis remains in fat gives very short penis.While erection having this much size will not create any problem in your sex life.So forget about size of penis and relax.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: Can clotrimazole cream applied on clitoris? Patient:Yes, today I was diagnosed with a yeast infection it was pretty bad and came on all the sudden so my gyn prescribed me a tablet to take for three days and clotrimazole cream to apply externally. It says do not enter intervagionally. Am I still able to apply it to my clitoris and around there because that is where my itching and swelling is. But I wasn t sure if I could apply to the clitoris because of it saying for external use only. Is clitoris external? Can I use this on my clitoris? Will it take away the itching and swelling? Thank you! [/INST] Doctor:Hello,This is Dr. Klarida Papaqako answering your question.I read very careful your concern. Clotrimazole can be safely used in all the vulvar area and in the clitoris also.It needs to be used twice a day.And yes, it will take away the itching. With the pill you are taking by mouth, it should be completely healed in max 5 days. Try to keep the area there, as much dry as possible, because humidity is one of the main causes of yeast infections.Hope this helps,Take care. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: MRI scan shows mechanical left recess stenosis due to disc extrusion, disc bulge. Suggestions? Patient:I have just had an mri scan which i would appreciate your help understanding mechanical left lateral recess stenosis due to left paracentral disc extrusion at L5 S1 with impingement of the traversing S1 nerve root . Annular disc bulge at L4-L5 . I have had symptoms for 9 months slow onset, I have had a caudal epidural and currently take gabapentin for neuropathic pain (pressure, heaviness up back). I have altered sensation in seat area, scatica (no longer painful altered sensation) and sitting ot walking a distance are problematic for me. I have been offered another epidural or surgery after a 1 month further increase in medication. Is this scan result minor or a concern, should I just continue, I am struggling to work Thanks [/INST] Doctor:Hi Alli, If your symptoms are sciatica on the left side, it corresponds with your MRI scan and the operation has a statistically greater probability of giving you good relief of the sciatica. In fact, in studies it has been proved that the major benefit from surgery is early return to work. However the choices on the table include surgery, interventional pain procedures like the epidural or continuing with painkillers etc. In the long term, none of these 3 choices have a particular advantage over the other. So you'll need to think through the pros and cons of all the options and choose whats best in your specific situation. Hope this helps </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Fatty liver, high BP. Taking cod liver capsules. Does it cause fatty liver? Patient:Hi Doctor, My name is Relton and i am 29 years old. Today i had been for a master health checkup and i was diagnosed to have fatty liver . How can i get it to normal condition? Also my doubt is i take Seacod Codliver capsules, per day 2, as i at times tend to have high BP , so was suggested to have seacod capsules. Does comsuming seacod cause fatty liver, as i am non-alcoholic and do not smoke . [/INST] Doctor:Hello, relton.alexander, Fatty liver is caused by various factors. Number one in western hemisphere is alcohol excess. The one we are seeing more commonly is a condition called "Metabolic Syndrome". This is associated with overweight. Type-2 diabetes or insulin resistance,high lipids and fatty liver of variuos grades. Codliver oil supplement is actually good for the body. It supplies Omega-3 fatty acids which are anti-oxidants and prevent cancer and boost your immune system. I recommend that you get a complete metabolic panel, lipid levels. thyroid function tests and a ultrasound examination of the liver if you have not had that. Losing weight is important along with regular excercise. Cut back on fatty foods , increase proteins in your diet. Take Vit-E supplement 800i.u. daily along with Vit-C 1000mg. daily. I am very glad that you are not a drinker or a smoker. I wish you well. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest treatment for endometrium cancer stage 1B grade 3 Patient:I have endometrium cancer stage 1B grade 3, clear cell with positive washings. I have done TAH-BSO 4 weeks ago. I will be undergoing radiotherapy (EBRT) 5x a week for 5-6 weeks here in Westmead Cancer Care siguro 1st week of January. No need to do Brachytherapy kasi daw di naman bumaba sa cervix. Wala pang Chemo appointment but I was already referred to a chemo doctor. Are these adjuvant treatment the best for my case? The RT doctor said the prognosis are not good but I am just hoping for the best. [/INST] Doctor:Yes the prognosis is not as good as the endometrial adeno carcinoma for the clear cell variant. Positive washings further impact the prognosis . lymphnode status was not mentioned in your query , if positive prognosis further falls down.Brachy is not useful as your disease is not localised.The adjuvant radiation and chemo plan is correct.A postive outlook impacts your quality of life in a good way which you need. Keep hoping for the best and stay positive . </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Negative aspect towards life, feeling bad on others success, recollect bad memories. Have loving family, stress free life. How can I overcome this? Patient:HI, My sister is 39 year old and married..She always think negative in every aspects. Other than close relative or close friends if any body(neighbours/relatives/friends) happy or doing progress in life, she feel bad. She don t have any stress as a house wife, maids are there for work. her In-law, husband and 17 old boy everybody loves her. She always remember bad memories of her life and start fight with everyone related to that matter. please help to solve her problem or suggest doctor. [/INST] Doctor:Hello Vijay, Welcome to Healthcare Magic forum. Your sister seems to be having a psychological problem causing paranoid thoughts and jealousy, anger, depression etc. This is common in people suffering from any disorders like manic depressive disorder, obsessive compulsive disorder or a personality disorder. The best way to confirm the diagnosis and start apropriate management is to consult a psychiatrist who after detailed examination can solve her problem. Please do not delay the consultation as in such cases the situation often worsens as time goes. In most cases the condition improves with medications like antidepressant or anti psychotic medications and psychological counselling. Hope this answers your query. Wishing her good health. Regards </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Is TAB UBICAR AND NEW BONA PLUS are safe? Patient:I am suffering from hyperbillirubinaemia. After that my body is not worked properly. In the morning season total body pain specifically upper portion of both leg. Doctor advice me to take TAB UBICAR AND NEW BONA PLUS. I want to know that the above mentioned two (2) drugs are safe. [/INST] Doctor:Hi, Yes, these medications are safe. Based on the history you seem to be suffering from painful nerve condition for which your doctor has prescribed these medications. Ubicar which consists of two anti-oxidants coenzyme Q10 and levocarnitine effectively used to treat nutritional deficiencies. Newbona plus contains calcium, L-methylfolate, methylcobalamin, pyridoxine and vitamin D3 and effectively used to treat deficiency states. They are considered to be safe. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Mohammed Taher Ali </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes vaginal yeast infections during menstruation? Patient:Hi, I've been suffering from vaginal yeast infections for the past 2 years. I experience this in the last few days of my period. My period is usually more brownish in the last few days and it gives me a severe stinging sensation whenever I pee and sex is completely out of the question. Even after my period the burning remains until I take some vaginal pessaries such as canesten. The creams do not help at all, only the pessaries seem to cure me from the burning. But then comes the next period and I have to go through this again. It seems that my period is acidic or something like that and I do not know what I can do :/ I'm 19 and do not suffer from anything else. Thanks! [/INST] Doctor:Welcome,Yeast is a fungus that normally lives in the vagina in small numbers. A vaginal yeast infection means that too many yeast cells are growing in the vagina camera.gif. These infections are very common. Although they can bother you a lot, they are not usually serious. And treatment is simple. yeast can grow too much and cause symptoms. A yeast infection causes itching or soreness in the vagina and sometimes causes pain or burning when you urinate or have sex. Some women also have a thick, clumpy, white discharge that has no odor and looks a little like cottage cheese.These symptoms are more likely to occur during the week before your menstrual period. you can treat yourself at home with medicines you can buy without a prescription. You can use an anti fungal cream, or a suppository that you put into your vagina, or anti fungal tablets that you swallow.If your symptoms are mild, you may want to wait to see if they clear up on their own. Take care. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What can be done when the fetus is having a disparity of 4 weeks (IUGR) with mild bilateral pelvicalyceal dilatation? Patient:Helo sir My wife now 39 week pregnant, on ultrasound scan it is found that fetus is is having a disparity of 4 week (iugr) and mild bilateral pelvicalyceal dilatation (right tpd 5.7mm left tpd 4 mm) what should. I do . Please help am little tensed. [/INST] Doctor:Hi, Firstly, there is a mild IUGR. Wait till 40 weeks monitoring fetal movements through NST test. Get delivered by 40 weeks if all normal and then baby care will be done by a pediatrician. The dilatation is insignificant and an ultrasound can be done for the newborn after delivery, this condition may vanish after birth. 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: What causes puffy eyes and rashes on face after an overdose of Buspar? Patient:After a night of drinking on an empty stomach, my boyfriend and I fought. In a fit of rage I grabbed a bottle of buspar (I was perscribed after a severe car accident for anxiety and my flashbacks) they were 15 mg bars i must of ate 16 or 17. my boyfriend panicked and stuck his fingers in my throat to male me vomit which was hard to do bc my stomach was empty except for the alcohol. i woke up this morning with my eyes puffy and red and some red blotches on my face. my right ear is sore. Could it be an allergic reaction? I never had that problem with this Med before. I have in the past had a similar reaction to effexor minus the ear pain and puffy eyes they gave me a steroid and atarax. Would it hurt to take the atarax to see if it takes the redness away? Its starting to itch. [/INST] Doctor:Hello, It could be an allergic reaction to the Buspar, but I wonder with everything that happened if it could be mild trauma to the face as well. If you are having itching, taking Atarax would be reasonable, or Benadryl. If you are having more swelling, or any difficulty breathing, you should go to the ER, but otherwise, if it is an allergic reaction, it should resolve in a few days. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Aaron Branch, General & Family Physician </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Numbness in the toes, pain in the stomach after unprotected sex. What is causing this? Patient:Hi. I had unprotected sex 2 days ago. Yesterday is when I started feeling numbness in my toes, sharp pains in my stomach , and diarrhea . My left breast is also sore. I haven t gotten my period this month so I don t know what to expect. During unprotected sex, my partner ejaculated inside me.. We had unprotected sex numerous times that day. [/INST] Doctor:Hi, Welcome to healthcaremagic Since you are not having period ,you should go for a check up to rule out pregnancy first. for the pain and soreness in breast a check up is needed to find the cause and treatment accordingly . hope you get well soon </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Cause of swollen gland under chin causing tightness in swallowing? Patient:Noticed in bed last night that the left gland under my chin was swollen - only the left. It doesn t hurt except a slight tightness in swallowing. I do not have any other symptoms. It seems to have gone down a little by the time I woke up - but now it seems quite enlarged again - like a very soft egg. I think it responds to cold a little - when I put my cold hand that had just held a cold water bottle to the site it seemed to retract slightly. [/INST] Doctor:HI.Thanks for a good history.This is swollen submandibular salivary gland. IT will be interesting to know whether there is a stone in the duct ( to be examined by an ENT Surgeon). If there is a some - a simple surgery will solve your problem. Get an opinion before complication of an infection. </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 am thinking like something unpleasant will happen to the family like plane crash etc.,? Patient:hi im noela im 34 yr old marred and having 2 boys one is 5 yr and auther is 2 yr. Im leading good happylife, my problem is i imagen thinks like if we alla go out in car i thinkthat what will happen if we met an accident or if we go in flite i thing whwt will happen if the filt is crashed and we go under water and what will 2 sons do under the water. i imagen how will thy hug me and cryetc.. i dont know what to doplease help me. [/INST] Doctor:Hello,Thanks for choosing health care magic for posting your query.I have gone through your question in detail and I can understand what you are going through.From what you have stated it is quite clear that you are having a depressive episode. Depression can occur with regular stress and it can also occur biologically without any stress as well. You need proper treatment for the same. There are various effective therapies for depression like fluoxetine, venlafaxine, bupropion, mirtazapine or escitalopram and they are all very effective and mostly safe. You may also require some benzodiazepines like clonazepam or lorazepam for a short period like 2-3 weeks to reduce the anxiety and help with your sleep. If you are averse to the drug therapies then there is also an option of cognitive behavioural therapy. This therapy is taken by either a psychologist or a psychiatrist in which the therapist identifies impaired cognitions (Thoughts) and try to correct them. They are 15-20 min weekly session and there should be around 8-10 sessions to help you with your illness.Hope I am able to answer your concerns.If you have any further query, I would be glad to help you.In future if you wish to contact me directly, you can use the below mentioned link:bit.ly/dr-srikanth-reddy </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes failure of ICSI after embryo implantation? Patient:Good Morning Doctor; I'm a married woman of almost 32 years old. I underwent 2 ICSIs during the last 3 months, but unfortunately the two trials did fail. I got the result of the second ICSI last wednesday and it was a "negative". I just want to know what can cause the failure of an ICSI after implantation of embryos... [/INST] Doctor:Hello, you should get PGD testing of embryos next time you go for IVF and also need endometrial receptor testingIn case you have any questions in future you can contact me directly on </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Cramps and spotting. Trying for pregnancy. Have thyroid problem. Any help? Patient:Hi I have been trying for a baby and tested yesterday, the 28 th day of my cycle, it came back not pregnent but I keep getting a bit of blood hardly anything for the past 3 days and stomach cramps as if I am going to start my period for the past week my monthly cycles are a bit irregular as I have thyroid problems e.g last month it was 26 days the month before it was 34 days. I'm I defiantly not pregnent. Thanks [/INST] Doctor:Hi,Thanks for the query.As your bleeding started there is less possibility for pregnancy.But if you think that the bleeding is abnormal for you and as sometimes urine pregnancy test kit may not detect early pregnancy, go for blood test for pregnancy or repeat urine test after one week.You have to keep your thyroid levels within control to get regular menstrual cycles and for fertility.For more details you can ask me through: care. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Are there any home remedies for treating blisters in the left thigh? Patient:on my upper, inside, left thigh-looks like a blister about 2 long and 1/2 wide. sometimes it pops (getting out of a chair) and very bloody. i weigh 350lbs on blood thinners. how should i treat this on my own? bandaids don t stay on/w niosporin. thanks rufus brown NO CREDIT CARDS. I M SORRY. [/INST] Doctor:Hello, Some advice that I can give to you is: -Wash your hands with warm water and antibacterial soap. -Using a cotton swab, disinfect a needle with rubbing alcohol. -Clean the blister with antiseptic. -Apply antibiotic ointment to the area. -Cover the area loosely with a sterile bandage or gauze. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Dorina Gurabardhi, 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 tiredness and leg pain while on Coreg, Toprol and Sotalol? Patient:My legs hurt and I feel so tired after I was switch off Coreg after bypass in May and put on Toprol, plus Sotalol after having pacemaker and defibrillator put in in November. Was throwing PVC s. They have decreased, but legs hurt now. Could these new drugs be causing this? [/INST] Doctor:Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. I would explain that your symptoms could be related to adverse effects of Toprol and Sotalol. I would not recommend taking these drugs concomitantly. You should discuss with your doctor on the above tests. Hope to have been helpful! </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Result says Distended gall bladder with 6mm calculus. Taking Uscorol since a month. Better medicine than surgery ? Patient:my test result says GALL BLADDER: Distended. Calculus measuring 6 mm is noted in gall bladder. COMMON BILE DUCT: Normal in size. I m taking 2 tablets(Uscorol 300 mg) every day from last 1 month. But, the size of the stone is decreased. Is there any good medicine available to dissolve the stones?. I am having very little pain(1 time in a week) in right hand side. Is there any surgery available to remove gallstone with out removing gallbladder? [/INST] Doctor:Hello Thanks for your query.You have been detected to have a distended gall bladder containing a stone of 6 mm size .Since you do not have obstructive jaundice and pain it is labelled as a silent gall stone .You may neglect it but you have to get your ultrasound scanning done repeatedly to watch the status of the size of the stone, Please note that there is no medicine that can dissolve the stone.Since gall stones are formed because of gall bladder itself been infected best permanent remedy is to get it removed by Laproscopic procedure which is very safe and result oriented surgery.. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes abnormal behavior with short term memory loss? Patient:yeah well my girlfriends had this thing all her life where she sorta zones out for hours like to the point where u cant get a word out of her and she like glides round the room if u know that i mean then she climbs up on her wardrobe with a blanket she's had all her life and sits there for hours on end without reacting to anything around her. when she finally comes out of it she cant remember anything thats happened to her and feels like its only been 15 minuets when its really been like 2 hours. its really scaring me and scaring her to as i have no idea what i can do to help her and who to ask about it. please help [/INST] Doctor:You should not worry. She may suffering from a treatable neurological or psychiatric condition.You should take her to a neurologist or a psychiatrist because the behaviour you describe may be an epileptic phenomenon (a complex partial seizure). He or she will evaluate her to get details of the episode along with any peculiar features that point to a seizure like activity. She may be asked to go for an electroencephalograph (EEG) which detects a seizure activity in the brain.Hope this answers your question. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest treatment for anxiety and depression Patient:hi please help. My son is 21 years old and suffers from anxiety and depression. However, in the last couple of days, he started having strange paranoia saying that we are (my husband and I) undercover cops out to get him. He has not been able to sleep and keeps staring out the window with binoculars saying that the neighbors are also after him. He is scaring me and my daughter and we don t know what to do. He is refusing medical help, but we can t keep him home because we are afraid he may hurt us. What can I do? [/INST] Doctor:Thanks for putting up your query on health care magic.Your son seems to be suffering from psychosis as he is getting suspicious about neighbours and his family without any reason.You should visit local psychiatrist and get him admitted where he will get required medications.There is also option of colourles and odourless medication available which can be mixed with food if patient is not ready to take medications. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: How can a sore lump on the neck be treated? Patient:My 10 year old daughter has been complaining of a sore neck to touch tonight. On examining her neck I found an almond sized and shaped lump which moves freely under the skin. I m in a state of panic now and hoping you may be able to shed some light on this. [/INST] Doctor:Hello. The lump most likely would be a lymph node. You are not to worry about it. It will dissapear as the sore throat settles. I would recommend salt or betadine gargle five times a day. And paracetamol if she's running temperature. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What does brown discharge and smelly urine indicate? Patient:I am prone to having UTIs and this is something that occurs often especially after intercourse, its been about a week and my urine is very cloudy with a weird smell and along with it some brown discharge that is mucus like. I have no pain and have already been on antibiotics and nothing is clearing this up..I have been hospitalized 3 times in the past 2 months because they have turned into kidney infections and have become very ill.. [/INST] Doctor:You don't state your gender, but I am presuming female and my answer relates to women. You might have a vaginal infection. That could cause a discharge with a funny smell, which would cause the urine to become cloudy. If the routine antibiotics used for previous UTIs haven't worked, then I would start thinking it was related to the genital tract. Bacterial vaginosis is a common vaginal infection that can cause a painless vaginal discharge. To be sure, you would need a vaginal exam with microscopic analysis of the discharge. You might also consider a clean catch urine for culture and sensitivity. If you have developed a resistant urinary tract bug, the antibiotics you've used in the past may not be helpful, and this test can diagnose the bacteria and what they're sensitive to for antibiotics. Hope this answers your question. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes movable lump attached to cartilage of throat? Patient:Hi there, I have a marble sized lump that is firm and moves up and down only when I swallow. It seems like it is attached to the cartilage in my throat on my right side. It is approximately 1-2 inches north of my adam s apple and to the right a little bit. My doctor recommened a sonagram. I am just worried. Does it sound like something serious. Thanks [/INST] Doctor:Hi,Dear,Thanks for your query to HCM.Studied your query in full depth of its details.Reviewed it in context of your health concerns.You seem to suffer from-Thyroid nodule.This is the lump to be worried and concerned.This needs to be thoroughly investigated for benign or cancerous lumps in thryoid.FNAC biopsy of the noduel would fix the diagnosis.Hope this reply would satisfy you and would help you to plan further treatmentwith your doctor there.Welcome any further query in this regard,which would be replied in next session.Will appreciate YOU,to write your excellent review feedback comments of this service experience, to help the needy patient visitors like YOU, at HCM services.Good Day!!Dr.Savaskar M.N.Senior Surgical SpecialistM.S.Genl-CVTS </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest remedy for severe pain in back with tingling in neck, hands and legs with blood report rf+ Patient:hi .................i m a 30+ working woman.......for last 3 to 4 months i have severe pain in my back with tingleing effect from neck with little siering in right and left side both hands and legs.....................could u help me plese.my blood reports has rf +. my physician has given me sazo 1000 and HCQS........... two tablets a day.......after taking them for 5 days i still had the pain [/INST] Doctor:Dear patient RA factor positive means you are suffering from rheumatoid arthritis which leads to multiple joint pains especially small joints of hands and feet. Sazo contains sulfasalazine which is disease modifying agent and it takes at least 3 to 4 weeks for its action to start. Till that time painkiller like indomethacin 25 mg thrice a day should be taken with it. Rheumatologist is best person.Tingling and numbness in upper limbs will be due to nerve compression in the neck and is separate issue from rheumatoid arthritis. Mri of the cervical spine with screening of whole spine needs to be done to confirm diagnosis. Meanwhile start tab pregalin x 75 mg one at bedtime for relief. Visit to spine surgeon with Mri report is needed. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest treatment for bruise and pain in knee Patient:I woke up this morning with severe pain in my knee and what looked like a red bruise to the left of my kneecap. Now after only a few hours it is a swollen itchy and blotchy red spot almost the size of my kneecap itself but still only on the side of my knee. What could this be? It is painful to put weight in it or straighten it [/INST] Doctor:Hi,Thanks for your query.According to your description , pain and swelling over your knee seems to be inflammatory in nature.I advice you to give you rest to the part affected, take anti-inflammatory drug like motrin 1tablet with food as and when required (upto 4 tablets daily) to reduce pain and inflammation and consult your doctor for thorough examination and rule out any infective cause.I do hope that you have found something helpful and I will be glad to answer any further query.Take care </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: How can chest mucus with wheezing be treated? Patient:My baby is 14 weeks old & has had mucus on her chest from birth. She is not getting rid of it at all. I breast fed her for 7 weeks. She is on Aptamil formula now. Every time I give her a bottle her wheezing gets worse. Do u think it s the milk that is making her worse?? I m thinking of changing to soya milk. Can u please advise. Thank u. [/INST] Doctor:HiBaby may be over feeding with bottle or regurgitating. Try to change to nipple with smaller hole appropriate for his age. keep him reclined with head slightly upward while feeding. Burp well after feeding and during sleep also support him in reclined position. If these measures doesn't help take help of pediatrician to rule out other anomalies like TEF & other chest infection/HRAD. For GERD antiGERD medicine may be required. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What can cause severe pain on the right side of the stomach along with fever and chills? Patient:Hi,Severe Discomfort/slight pain on far right side of stomach below rib cage - like I was punched...no appetite...upset stomach feeling - sour taste in mouth...intermittent fever, chills, one case of severe vomiting, sore throat - since last Friday...bowel movements normal. [/INST] Doctor:Hello, A case with pain right upper abdomen with fever and chills must be addressed for gall bladder infection with some sort of bacteria or else. Though primary relief can be obtained via anti-emetic medicine and analgesic as acetaminophen, I would suggest getting an ultrasound of the abdomen & pelvis done for best diagnosis and management ahead. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Bhagyesh V. Patel, General Surgeon </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes low blood sugar to happen in the mornings? Patient:I have low blood sugar, I've had this for at least 20 years or so. I have been trying to control this by eating every 2 to 3 hours staying away from all spicy and greasy foods no coffee or sodas or sweets pretty boring but it does work for me. My question is why does this problem I have only happens in the mornings when I wake up . [/INST] Doctor:dear sir I can understand your concern in my opinion you need to check for serum c peptide and insulin assay it might be due to excess insulin secreationI suggest you to see a endocrinologist for further evaluation </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What do pregnancy symptoms and negative test results indicate? Patient:Hello, so feb 18 i had unprotected sex 6 days later i got my period (my cycle is about 21-24 days long but very irregular). I had unprotected sex on feb 26 (day after my period), march 10, and 12. today is march 15 and i took a pregnancy test and it came out negative. I feel sick quite a bit, i feel rather bloated, my breasts have slightly enlarged, what i would really like to know is if you think i am pregnant [/INST] Doctor:Hello, and I hope I can help you today.If you are having unprotected sex, there is always a possibility you can become pregnant.However, pregnancy symptoms can vary a lot between women, and even the stress of worrying about pregnancy can make your menstrual cycle irregular. And breast tenderness, feeling bloated and tired can all be premenstrual symptoms.The only way to be sure if you are pregnant is to wait for your period to come, and if it does not on time, take a pregnancy test. It will not become positive until at least 3 weeks after conception.I hope I was able to adequately answer your question today and that this information was helpful. Best wishes, Dr. Brown </s>