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<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes pea sized immovable lump on sternum? Patient:I m a 31 yr old female. Recently I had what I thought was a boil pop up in between my breasts. I tried popping it, but it only got very little thick white pus out of it. It looks like a small pimple now, but under it I can feel a rock hard pea sized immovable lump on my sternum. Is this cause for concern? [/INST] Doctor:HI. This is a sebaceous cyst which you have popped.The hardness is the remains of the cyst and as the skin is tight over the sternum in this area and the tissues are more prone for the development of scar in this particular are. Leave it as it is at the moment as mishandling can cause a bad scar particularly in this area. Consult a Surgeon and get this removed and to undergo further management to tackle the scar formation. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Q. How long should my husband and I wait to try for a baby if we did cocaine? Patient:Hello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance. [/INST] Doctor:Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more 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: Is it normal to have back pain and stomach ache while losing breath constantly after a neck surgery? Patient:I had a neck surgery, my specialist fused 3 verta. in my neck, and I have been suffering from dryness, choking horriblably, which I am losing all my air for at least 5 mins, just trying to get my air back, it causes all kinds of back pain and stomach aches...whats wrong? What is out there for me to help? [/INST] Doctor:Hi there. I think you might be suffering from a nerve root irritation or compression which might have happened at the time of surgery.For this an immediate MRI needs to be done to find the site of compression. You need to be kept on oxygen inhalation.Stomach aches could be due to side effects of the medicines which are being given to you. Good luck. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest medication for pain relief due to spine crumbling Patient:have been taking pregablin for nerve pain due to 4 5 and 6 spine crumbling but now find that they are causing mental and suicidal feeling, what else can I take to take pain away. I cannot take NSAIDS as had kidney removed as have RCC. Previously was on Pregablin was on gabapentin these altered my mind [/INST] Doctor:Hai, pregablin and gabapentin are the best products for ur roblem and safe on kidneys too.qmost commonly other than addiction it does nothav any other significant side effects as wat u hav mentioned.looks like u r going into depression due to ur long term illness.pls visit apsychiatrician, u need a good counselling. For pain u can also try with tapendetol (tapal er).pls dont get depressed good luck </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes inability to walk straight? Patient:While walking, I tend to lurch to the left or right I can correct each movement, but that causes me to move in the opposite direction. The sensation varies in affect. When sitting, the problem does not show. I am 76 years of age and a type 2 diabetes. [/INST] Doctor:Hello, Most probably it is due to neuropathic weakness of your arising out of uncontrolled diabetes. Consult a neurologist and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Shinas Hussain, General & Family Physician </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suffering with jaundice, suspicion of blood disorder causing reduction in RBC. What may be causing this? Patient:My sisterin law had ,what they thought was jaundice; and now is saying she has a blood disorder that is eating away her red blood cells. Is there anything you can tell me or maybe tell me what is causing this? And by The Grace of GOD and GODLY Doctors ,you can help. Thank You and MAY GOD ALWAYS BLESS YOU. Sincerely, Robin Sears [/INST] Doctor:Jaundice is not always caused by liver dysfunction. Certain disorder that cause destruction of red blood cells (Known as hemolytic syndromes) also cause jaundice. The simplest way to determine this is if the indirect bilirubin fraction is more than direct fraction- hemolytic syndrome is likely. Please send me the following details 1. complete blood counts- hemoglobin, total count, platlets etc 2. Utrasound of abdomen 3. complete liver function test- bilirubin- direct/ Indirect fraction, ALT, AST and ALP. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Periodic swelling and pain in skull. Histroy of tumor. Prognosis? Patient:Hello Doc, I had tumor back in 2001, and since the like every six months to maybe once a year my skull swells and hurt tremendously. I've went in and had it check but the was no diagnose done. One Doctor told me to go in when it swells. It just resently swelled that is why I would like to hear your prognosis of what it could be and what should I do? [/INST] Doctor:Hi, What was the size of the swelling? what was the consistency? is there any cough impulse? anyway a swelling should be examined clinically. Proper diagnosis to be made first. You should go to a general surgeon. He will try to assess the origin of the swelling. Prognosis will depends on that. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest treatment for hallucinations when diagnosed for psychosis Patient:HiI have been diagnosed with psychosis and am on Haldol (fast acting) I tend to see images of people or characters when I close my eyes or see a blue sillouhette of a child or see 3d simulations of objects on the top right hand side of my vision. More recently however, I have started feeling a sensation on my forhead or bouts of pain around my eye region. What could this be? [/INST] Doctor:Hi.I understand your concern.Hallucinations are part of psychotic illness and can be treated with anti psychotic medicines.Haldol is first generation anti psychotic and gold standard to treat psychotic illness.Machanism of action is slow and take time to achieve complete recovery.Add on another anti psychotic probably second generation is advisable for resistant cases of psychotic illness.Long term treatment compliance is must for better treatment.I hope I have answered your question. Thank 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: Suggest treatment for slight pain in lower abdomen Patient:Right now i am having slight pain in my lower abdomen. My stomach has been hurting since yesterday when i got up in the morning. It wasnt hurting that bad. it was tolerable so i just took some motrin and went on with my day. After being awake for probably 5 or 6 hours, the pain started getting worse. It went from tolerable to unbearable in about 5-10 minutes. The severe pain probably lasted somewhere between 30min to an hour. I was in so much pain that i didnt even notice how long it was. I was almost crying in pain. I laid in my bed and i was doubled over in pain. I could hardly move and it hurt to breathe. It eventually went away after 30 minutes or so but it hurt so bad. It was the worst pain i had ever felt. I was so close to calling 911. The only reason that i didnt was because when i was thinking about calling 911, the pain was starting to get a little better. The severe pain lasted from 30 min to an hour and when it started to calm down it went from unbearable to tolerable again in about 5-10 minutes. I still have a slight pain right now but its nothing too bad. Im just scared that it might happen again. Anybody have any idea what that might have been. The severe pain is gone now so should i still be worried. And by the way I dont have a fever, im not throwing up, and i dont have any other symptoms. And im and 18 year old female if that helps with anything. Should i still go to the doctor because the pain im feeling now isnt really bothering me. Thanks for any help. [/INST] Doctor:hi.observation may be done for now, especially if the pain has subsided. also, do you have menses, or in midcycle, when you experienced that pain or none? if there's any recurrence, you might want to have a consult with a gynecologist. possible causes of your lower abdominal pain are infection (UTI), gynecologic or gastrointestinal in nature. physical examination is warranted and diagnostic evaluation (such as ultrasound) will be directed accordingly.hope this helps.good day!!~dr.kaye </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 ITP and high liver enzymes? Patient:My son was diagnosed with itp and after the liver enzymes are high doct ordered MRI was normal. He want do do biopsy. But the itp is controlled only once a year he gets treatment and last for a year . What is the best We are skeptical for biopsy and the hematologist dos not make a big deal what do you think [/INST] Doctor:Hi and welcome to HCM Thanks for the query. Itp usually can be controled for many years and high liver enzymes can be seen occasionaly if there is significant hemolysis. if there is no critical fall in hemoglobin then no treatment is necessary. if there will be need,then splenectomy can be done and it will be final cure for itp.Wish you good health. Regards </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Have muscle pain, anxiety, ear pain, stomach upset, numbness in cheeks and tingling sensation. Taken Plan B. Are they side effects? Patient:Hey. I m 19 years old and I took plan b about three weeks ago. I had mild side effects such as mood swings, muscle strains, headache and more. When I took it about 3 years ago I was suffering from numbness of the face, hands and feet.. Muscle pain, intense ear pain with tingling in my head. Anxiety and stomach upsetness. I noticed that as I get older the side effects become less and less. But i noticed something unusual about this time, even though i was getting my hopes up of not getting any serious side effects. I noticed that when i turn my head to a specific direction, there is a crunching noise in my right ear. And again, i m in perfect health never had any health problems but these stupid side effects that plan b causes. I m wondering if this is all in my head and if i should just wait till it goes away.. i mean it doesnt hurt or anything. I can live through it. also my chin and cheeks tend to get numb and tingly. Any suggestions? Is this normal? Do i really need to go to the doctors for this? [/INST] Doctor:Hi,Thanks for the query. Plan B contains levonorgestrel.It can be used for emergency contraception. Usually emergency contraceptive pills present with symptoms like nausea, breast tenderness, bloating sensation etc. For more details : causing neurological problems is somewhat abnormal with contraceptive pills. They can cause headache, dizziness etc. But pain in ears, numbness etc are not common side effects of emergency pills. So, if the symptoms persist, once consult ENT surgeon and get examined to rule out any ear pathology. If no abnormality is detected, the symptoms could be psychological and possibly subside soon. Better to avoid repeated intake of emergency pills. Take care. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Could the whooshing sound have been pulsatile tinnitus? Patient:I recently was diagnosed with bronchitis. I was given antibiotics for it and I have been taking them for about three days. The period of time (2 weeks) I suffered from the symptoms of the bronchitis without going to the doctor included the development of a whooshing or rushing sound in my left ear. I ve been looking this symptom up and I was wondering whether or not it was pulsatile tinnitus and if this symptom is common with upper respiratory tract infection. [/INST] Doctor:Hi, The way you are describing it, the possibility of tinnitus is more likely. And tinnitus is common after viral upper respiratory tract infection (URTI.) No specific treatment is required for tinnitus except symptomatic treatment for URTI. So do warm water gargles and steam inhalation 4-5 times a day. Drink plenty of fluids orally and keep yourself hydrated. Take antihistamine drug like levocetirizine or fexofenadine. Don't worry, you will be alright in 1 week. If tinnitus is persistent after 1 week then consult ENT doctor. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Kaushal Bhavsar, Pulmonologist </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What type of diet is good for a 1.2 years old with high fever? Patient:my son last 3 days before admitted in CMC hospital in vellore tamilnadu.because of 106.3 fever.and last month also it s happened.the doctors collected all blood samples and urine culture reports.but he tell the my son have an Hb : 9.9gm% only.he is an 1year 2 months old boy baby.which type of food i want to given to my son..if i give any food means immediate he is vomiting only please suggest for way of types and food types to serve my son..he is 6.8 kg only.birth time weight is 3.25kg. [/INST] Doctor:Welcome to healthcaremagic,Your child had normal birth weight of 3.25 kgs but now her weight is only 6.8 kgs as against the expected 12 kgs. Your son has a Hb of 9.9 gm% which is less than normal and is referred to as anemia. The most common cause of anemia in children in India is because of iron deficiency in diet. Very children in India also have anemia due to a disease called as thalassemia. I recommend you to get a blood test of your son for blood iron levels and Hb electrophoresis. If your baby is suffering from iron deficiency anemia then he has to be iron rich foods such as green leafy vegetables, beans, chicken, fish and meat. As your baby is also underweight you need to give him high protein and calorie food such as more of milk, egg, fish, toffees, nuts, green leafy vegetables and fruits. Hope that answers your question,Regards, Dr.Imaad. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes pain in chewing after wisdom tooth surgery? Patient:I got my wisdom teeth surgery 3weeks ago and im eating normally and chewing.food normal on my right side it doesnt hurt but on my left side I have a hard like ball in my gums and dont know what it is it burns.and throbbs alot and my cheek turns red what is it and how can I cure it [/INST] Doctor:Get An IOPA Xray and you need to consult if the cheek is also turning red.Is this the same side that you got the tooth extracted from. Warm saline rinses can be useful aids. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Is pregnancy possible through non-penetrative sex? Patient:I fingered my girlfriend last week (Dec. 8, 2015). I think there were precum on my fingers and I also rubbed my penis on the outside of her vagina. And there were also precum on my penis. Could she be pregnant? Yesterday, a week after that happened, she told me her abdomen hurts and there was a little blood on her napkin. She is irregular so I don t know. [/INST] Doctor:Hello dear,I understand your concern.In my opinion the chances of pregnancy are less as the semen ejaculation was not done inside or around the vagina.The precum on fingers and penis causing the pregnancy is very very rare.Nothing to worry.Also the symptoms of pregnancy are nausea,vomitings,increased urination,sore breasts start 2 weeks after missed period in case of pregnancy.The first sign of pregnancy being missed period.It is too early to feel any pregnancy symptoms ie., just a week after intercourse.The pain abdomen and bleeding might suggests the periods might start.So relax.The pregnancy appears to be a rare or nil possibility.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: Suggest remedy to get rid of teeth getting yellowish Patient:okay doctor sahib, i hope that u will be fine there, kindly help me in this matter that my teeth are yellowish day by day ,i used all kind of medicated tooth paste & maswak but not okay ,there4 plz give me a good suggestion for better health care, i m waiting 4 ur kind response,ur best frien shaheen jan [/INST] Doctor:Thanks for using Health Care Magic.Read your query.Yellowish color of the teeth can be due to many factors including improper brushing ,heavy intake of caffeine drinks,also due to increase in age and many others.I would advice you to visit your local dentist and get your teeth cleaned and polished.Follow the post cleaning instructions with proper brushing and flossing.Use antiseptic mouth was for a while.Hope this was helpful.Thanks and warm regards. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Q. I am severely anemic. Kindly help. Patient:Hello doctor, I am a severely anemic patient. I have been on iron and B12 shots for three decades, but still, there is no improvement. I have got enlarged spleen, IBS, and also no absorption from the gut. I had undergone so many tests but nobody seems to have answers. I stay exhausted, dizzy and pale. Can anything help my severe anemia? [/INST] Doctor:Hi. As you are on iron and vitamin B12 shots, I would assume that it could be nutritional. It is obvious that no absorption from the gut and also IBS will complicate it. Enlarged spleen could be due to increased destruction in spleen or production of cells in the spleen to improve anemia (extramedullary hematopoiesis). I would like to know the following details: </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest treatment for severe pain due to varicocele and bleeding during ejaculation Patient:hiI am a male 22 years. i have vericocele veins on my left side testicals. Few days before i started feeling extreme pain in my testies. When i Masturbrated sperm was low and yellowish. There was a drop of blood as well. I took antibiotics ( amoxycilin). So every time i Masturbrate it pains a alot. Any suggestions. [/INST] Doctor:Thanks for contacting HCM with your medical questions.I am sorry to hear that you hare having pain on ejaculation and blood in your semen. These symptoms along with the pain in your scrotum usually indicate infection in the prostate gland. The antibiotic you took amoxicillin is not powerful enough to treat the prostate infection. I recommend that you seek medical attention to be treated for prostatitis which is an antibiotic for 4 weeks.In summary I think you have prostatitis and you need to seek medical attention for full treatment of your infection.I hope this answers your question. Please contact HCM again with any of your health care concerns </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Is anti rabies injection necessary after being bitten by vaccinated dog? Patient:sir, i have a dog 2 years old and immunized for anti rabies for the past two years last dose was given to it last month. 2 days back some stray dogs attacked my dog and has bitten him. yesterday my dog bitten me too on my hand. i have cleaned the wound with soap and dettol. there is no deep cut only the skin has cut. and minor bleeding. do i have to take anti rabies injection. [/INST] Doctor:Hi, Thanks for posting in HCM. I understand your concern. The current exposure falls in category 2 and carries certain amount of risk. Hence, a complete course of anti-rabies vaccine needs to be taken along with the local wound care. As per WHO post-exposure prophylaxis recommendations, one dose of the vaccine should be administered on days 0, 3, 7, 14 and 30. Hence, kindly complete the course of the vaccine as per the prescribed schedule. Hope the information provided would be helpful. All the best. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Q. Why does not my foreskin retract? Patient:Hello doctor, I have a major problem with my penis regarding the foreskin. I am 18 years old and the foreskin still does not go back. Please suggest some solutions for the above problem. [/INST] Doctor:Hi. The most common cause of the condition is poor genital hygiene. You see a lot of dead cells and bacteria get collected in the space between the head of the penis and foreskin, making foul smelling grayish white substances, known as smegma, to come out. If you do not clean it daily by retracting your foreskin, it may lead to chronic infection and inflammation. Such chronic inflammation causes the foreskin to get adhered to the head of the penis. This condition is called phimosis. Try to retract the foreskin while under the shower using mild soap as a lubricant. If it does not get retracted and cause severe pain, then you will have to visit a surgeon to cut of the extra foreskin and expose the glans of the penis. It is a minor procedure and will have an extra benefit of having clean genital. For more information 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: Delayed periods. No contraceptives, only withdrawal method used. Does this delay periods? Patient:i am 24 and have a 6months baby boy ever since i gave birth my period cycle has been changing from 21 to 25 days recently i have been feeling moody,sore n dark breasts,frequent urination and a missed period i tested for pregnancy after 12 days of unproctected sexual intercourse but the test was negative for contraception i use withdrawal method what could be delaying my period? [/INST] Doctor:Hello dear delay in period os quite common after delivery,,,,i hope you are feeding your little one,,,,actualy the hormanal levels get variation with the ampunt of milk the baby is taking ,,,and hormones control your cycle,,,,,secondly sometimed because of stress you also get delay period,,,,withdrawl method is safe to the time uptill your partner ejaculate outside,,,,why not try physical barroer method thats perfectly safe,,,,take care </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What remedy is suggested for pain in big toe post a plate removal? Patient:My friend had a plate rmoved from her big toe because it was causing her a lot of pain! This was done on December 10 th and she is worried because it is still not healing. she is just given a dry dressing at hospital but in my oppinionit should have healed by now. Is there more she can do herself to make it better? Diane [/INST] Doctor:hi.thanks for using hcm.as such nail injuries are more painful due to rich nervous innervation.it is a superficial injury,which should not be always covered.but keep it free from contamination or infection.please keep the wound open over night,by just cleaning with normal saline.please ask her to check her sugar levels due to the non healing of the wound for longer time.do not worry it will heal ,she can go for a course of simple antibioticstake care </s>

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

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest treatment for severe wrist pain and arm pain Patient:While tightening down a swridt crew, my hubby heard a pop in his wrist. He instantly said it really hurt, and he was holding his arm. He is a stubborn man, and now says it is okay. However, he is babying it, and I know he is in pain. What could possibly be wrong, and should I take him to be seen? [/INST] Doctor:Hi,Thanks for your Queryyour husband seem to have injured a ligament in his wrist. He should :1. apply ICE PACKS 4-5 times a day2.use a wrist splint to give rest to the injured ligament3. take rest,avoid using his affected arm as little as possible4 .take antiinflammatory like ibuprofen for 5-7 days hopefully it should improve in 10-14 days.hope i have been of help to you.if satisfied,please don't forget to rate my answerThank you </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes lack of fetal movement during pregnancy? Patient:pregnant woman 34 weeks pregnant, she is not feeling any movement from the fetus in approximately 2 hours. She has attempted to re-position the fetus, no response of any kind from the fetus, she has consumed food in an attempt to stimulate movement, still no response. she is not sure whats happening and the next course of action to take [/INST] Doctor:Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice.The possible causes of decreased or lack of fetal movements are :With increasing gestational age as the baby increases and amount of amniotic fluid decreases sometimes movements may not be appreciated with same intensity as in lesser gestational age.Sometimes because of sleep wake cycle also around for one hour baby movements may not be appreciated.But but really there is possibility for signin fetal distress which should not be overlooked.So, as she is not having any fetal movement for 2 hours even after all attempts better to consult your gynecologist once, get examined if needed undergo ultrasound once to find out the well-being of the baby.Fetal Doppler is a small equipment which helps in finding the fetal heart rate that can be used at home also and helps in monitoring the well-being of the baby. If you want you can purchase one and can use at home. Hope I have answered your query and I will be happy to answer any further follow up queries. Take care. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Is there any side effect after consuming expired medicine? Patient:My 7 year-old son had a fever 4 days ago, I gave him an ibufropen 3 times before discovering that the medicine has already expired. Today, he has fever again. I am worried that it might be the effect of the expired medicine. What is the effect of taking in expired medicine. Do I need to take my son to the hospital? [/INST] Doctor:HiExpired medicines lose their potency and will not be efficacious when used. Otherwise, they do not cause any side effects. Certain preservatives used may cause any allergic reactions or vomiting. In case of such symptoms, the child requires medical examination. You should also use new ibuprofen since fever may not be reduced with an expired drug.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Saranya Ramadoss, General & Family Physician </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What are the chances of ovarian cancer? Patient:Im 65 year old female and the tingling in my hands arms legs and feet go on all day and night. My fingers on my right hand are starting to cause some pain and itching. I just had a ct and mri of stomach and pelvic looking for kidney problems etc, and I do have a 2cm cancer on my kidney. I read a lot of the internet about the causes, like MS and other neurological problems. I am experiencing extreme anxiety over the past four weeks due to an ovarian cancer scare and the kidney result. I am otherwise healthy, except for acid reflux and high cholesterol. I just started taking lipator and am using dexilant for GERD. [/INST] Doctor:Hi,Thanks for writing in.If you have got CT scan and MRI scan of abdomen and pelvis that confirms normal ovaries then it is unlikely that you have a ovarian cancer. The 2 cm ?cancer in the kidney is a concern. A 2 cm lesion in kidney is a small one but requires complete evaluation and treatment as the report says about a probable cancer in the area.Any cancer can cause symptoms like weight loss more than 10 percent in two months that cannot be explained, generalized weakness and fatigue, swellings in the body, blood counts going down, easy tiredness. In addition, ovarian cancer can cause a swelling that is rapidly growing in the lower abdomen that might cause little pain. It can also cause fluid collection and ascites. At 65 years age it is menopausal so menstrual disturbances might not be present. There are blood tests for tumor markers like CA 125 which tells the likelihood of ovarian cancer in women.Since your report does not say anything about ovaries please do not worry. You should be concerned about the suspected kidney tumor and get it evaluated in detail and take treatment. Your cholesterol and GERD treatments are to be continued. Please do not worry. </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: Sharp ripping pain in lower left abdomen, ultrasound shows hernia, dark spot on uterus. What could be this ? Patient:Hi, I had a pelvic ultrasound today because I ve been suffering from a sharp ripping pain in my lower left abdomen. My first ultrasound showed up a hernia a little above my belly button but my pain was on the left lower area of my belly button. I went to the doctor the week later because the pain had spread to the mid lower abdomen. This is where I just had this ultrasound where I noticed a dark triangle shape area on my uterus that the lady was measuring. What could thus be? AAAA [/INST] Doctor:Dear Simone, there is one rule for doctors here in Croatia: when you think too much,stop, and think again, but this time think for the simpliest diagnose. If you have pain in abdomen and an umbilical hernia seen on US then the first thing to think about is "abdominal pain caused by hernia":) . There are many conditions in medicine where pain doesnt need to bo localized near the "patology". Sometimes pain can be felt on the opossite side of the affected organ. It is known that one of common symptom of myocardial infarction is pain in the left shoulder. Also, infection of the abdominal organs can give many types and localizations of pain. The reason for it is simple: when i see pain, i see nerves, not organs (this is my own phrase:)) . Nerves conduct pain, and nerves are all around, going from perifery to the brain so pain can be localized on its pathway, So just lets go back to your problem. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Small cell lung cancer metastasized to liver, chemo done. Has abdominal swelling, weeping edema, side pain. End stage? Patient:my sister has small cell lung cancer that has metatasized to her liver she has had chemo tx 2 times and just completed 5 weeks of radiation she is having side pain and abdominal swelling and weeping edema in her lower extremities my question is: what can be done about this and is this mean that the cancer has progressed to the end stage [/INST] Doctor:Hi, I feel she has major liver function abnormalities and due to low serum albumin level, she is getting lower limb swelling and abdominal swelling. May or may not be due to disease progression. Important thing for her is to maintain serum albumin level with good oral nutritional supplement. If oral intake is poor, then par enteral nutrition would help. Take care. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes tender lumps on head? Patient:I have had several sudden unexplained lumps appear on my head. This started a few days ago. The lumps are tender. They start small and within hours it can become the size of the palm of my hand. They seem to disappear as they expand. Edema is also present for a short time over the swollen area. Can you let me know what some possibilities could be? Thanks [/INST] Doctor:Hi,From history it seems that this might be due to some allergic manifestation due to some allergy or some scalp infection like fungal infection, dermatitis or dandruff.This can be due to some chemicals used as shampoo, conditioner or head bath lotion.Try to find out the cause and avoid it.Take Cetrizine or Levo-cetrizineor Benadryl for 2-3 days.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: How to treat bruise located in the middle of spine? Patient:Hello i am 17 and i have a bruise located in the middle of my spine that has been there for a while. It just recently got really red, sensitive to the touch and when you press right next to it, it sort of feels like a sponge. Any idea what it could possibly be? [/INST] Doctor:Hello!Welcome on Healthcaremagic!The bruise in this region could be related to a lipoma, which is a benign tumor. But, I recommend consulting with your GP and performing an ultrasound of the soft tissues in this region, in order to examine better the lump nature. Hope you will find this answer helpful!Kind regards, Dr. Aida </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest the best treatment for dry cough during pregnancy Patient:Hi, I am running my 6th week of pregnancy. I am having very severe dry cough since 5th week. Steam inhalation, hot water therapy etc isn t helping at all. Not able to sleep at nights. Can you please suggest anything to get rid of this irritating dry cough? Also is kanthil safe to be used? [/INST] Doctor:Hello, I suggest you take syrup honeytus 2 tsf thrice in a day for at least 5 days and saline gargles and steam inhalation May also help in resolving your dry cough. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Naira Jahangir, OB and GYN Specialist </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Can the baby's heartbeat show up after another two weeks? Patient:hi this is muna actually i am pregnant now for 6 weeks and when i did an ultra sound their was no heart beat as for the beta hcg test shows that it is nearly to 1130.0 and the sack did not grow bigger but little bigger like it is in the 4th week so is their any possiblity that the heart beat showed after two weeks [/INST] Doctor:It is less likely it will reappear , but at the same time, you shoyld have another pelvic sonogram to make a final diagnosis and treatment. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What is the composition and formula of EVION? Patient:I'm24years old,my height is5.7&weigh around 60kg...i got married a year ago & now try to conceive bt didn't get successful..My gynaecologist suggested to take CLOMID tablets along with VITAMIN E(EVION) during 5 consecutive days of menstural cycle..May i know the composition &formula of EVION because there is no availbility of EVION in my country [/INST] Doctor:HIWell come to HCMThe pregnancy is more natural phenomenon the physiological one and this does not need any treatment, it is all depends upon the compatibility, like presence of ovum and sperm at the time of ovulation with normal parameters if this is not there then pregnancy would not be possible what ever medicine you take that are questionable, hope this information helps. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What are the symptoms and treatment for low blood pressure? Patient:I recently attempted to donate blood at a Red Cross blood drive but was advised not to donate when my blood pressure registered at 80/50. My readings are normally around 108/70 or within two to three degrees within this range. What causes low blood pressure and are there any symptons? [/INST] Doctor:hilow blood pressure can cause generalised weakness , myalgia, nausea, giddiness, black outs, cool feet and hands due to inadequate blood supply.many cardiac problems also lead to sudden hypotension, vasovagal, syncopal attacks, if present since longer duration should be evaluated.postural variation & severe infections can also lead to hypotension.good intake of fluids and nutrition will correct the hypotension many a times.for the sake of blood donation you require mean arterial pressure between 70--110 mm of Hg. all the best, take care. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Q. How to get TSH level control in a diabetic? Patient:Hi doctor, My dad is 67 years of age and my mom is 63 now. I have got general health checkup done for my parents. I am uploading the reports here. Kindly check and let me know if anything needs our immediate attention. Thanks [/INST] Doctor:Hello. I have seen all the reports (attachment removed to protect patient identity) of your parents. Your mother is diabetic and she is controlling her diabetes good. She has a mild increase in her leukocyte count, it is due to infection. Did she get any fever in past weeks? Or did she have a sore throat? Is she taking any thyroid medication? If yes, which one and what is the dosage? Her TSH (thyroid stimulating hormone) is high which means there is thyroid disorder, but to be hundred percent sure you need to do TPO (thyroid peroxidase antibody test) it will tell us what exactly the problem is. Your father probably does not have diabetes as you have done HB1AC (glycated hemoglobin) and FBS (fasting blood sugar) test first time on him. But I think he is a little obese. He should go for a walk for 30 minutes and reduce the fat and oil from his diet. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: How to reduce stress in life? Patient:I am under a lot of stress right now, my husband surgery, me working, not enough time to do everything, no one to help me, every day late afternoon I feel like I can't breathe, same thing when I get home & see equipment all over the place, then I go out walking w/my dog and come back feeling better. [/INST] Doctor:DearWe understand your concernsI went through your details. I suggest you not to worry much. You are lucky. You are managing well. There are so many people who does not. Let me assure you. You are on the right path. Everyone are stressed in one way or other. How to manage. Thinking that they are stressed increases the stress and they become more worried. Running away from stress is possible for some time. But stressful situations come again and again. Where to run? The only way out is to understand and stress and live happy with the stress existing and you not worrying about it. There are several ways like Cognitive Behavioral Therapy and Logo Therapy. Prescribing a therapy here is beyond. You can ask a premium question to me with all possible details. Be as descriptive as possible. I am sure that you will be able to manage stress successfully. Hope this answers your query. Available for further clarifications.Good luck. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes infants to cry suddenly? Patient:Hi Doctor! last night my son was quietly sleeping when all of a sudden he cried, I didn t know what actually happened to him because he is just 1 year and 8 mos old and can t speak. I thought he was just hungry so I prepared him milk but he didn t want it. He played for a while and get back to sleep, hours later he went crying again. Why is he like that? Is there anything wrong with him? [/INST] Doctor:HI...there could be two possibilities in infants crying like this suddenly - First and foremost being - Otitis media or middle ear infection.Secondly could be due to excessive gaseous distension int he intestines.For the fist - I suggest you see your pediatrician and for the second I am giving an explanation here which might help you - This is called evening colic and is quite common in this age group. This happens when the baby sucks at the breast very fast and in eagerness to drink milk will gulp in air too. Unless the air comes out like burping or flatus this discomfort will be there and next time check if the baby is sucking too fast and gulping in air too. You will be more convinced. Usually I don't advice any medicines for this as they give only temporary relief.The two best ways to relieve this distress is - 1. Do not put the baby in lying position after feeding till the baby burps out the swallowed air.2. If still crying - put the baby in prone position and keep patting the back gently so that the baby passes off the flatus and gets relieved.Regards - Dr. Sumanth </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Q. Please suggest an alternative medicine for Lamictal. Patient:Hello doctor, I am 61 year old and was lately diagnosed by a doctor as sick in fibromyalgia. In the last three years during the night time, I am suffering from aggressive involuntary movements while asleep. Those movements include kicking in the air and arching and bouncing my back and the whole body. At first those aggressive movements started as a physical response to a dream where I was being attacked which happened once in a while, lately, it happens more and more often without any noticeable reason. As a result of the movements, I suffer from strong pain in my back and knees which lasts for a long period of time and restrict me to my house. I am also very depressed of my physical condition which projects to anything I do in my private life, family life and job. I quit my last job a year ago due to my medical condition. Can you please advice on physical/neurological treatment that will improve my poor physical and emotional conditions? In addition, I am using Lamictal 200 mg which according to the medicine brochure might rarely cause involuntary limb movement. Therefore, I wish to replace it with equivalent medicine. Can you please advise on a possible replacement? I have already tried Seroxat, Depalept, Gabapentin, Lyrica, Teril, and Cymbalta which did not help. [/INST] Doctor:Hello. Well, these involuntary movements do not sound normal at all. It looks more of chorea/hemiballismus (movement disorder). It can be drug-induced but at the same time considering your age, we should get an MRI scan for the brain done. If any problem there, we will have to treat it differently. I understand you have tried a lot of drugs. Tablet Lamictal (Lamotrigine) can cause involuntary movements but not to the extent you have. First, I suggest you consult a neurologist first and get your drugs sorted out. Secondly, you can try with Amitriptyline or Mirtazapine as the drugs for fibromyalgia. They do not have that many side effects and may give you improvement since the others have not responded. I would also recommend you to do meditation or yoga as it does play a big role in helping patients with fibromyalgia. </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 low WBC count Patient:My son has had a really high fever of 103,4 for over 2 days. Today i took him to the er. They said it was a uti and that his white cell blood count was low. I also just found out that crones diease runs in my husbands family. Could this low white cell count mean my son has this diease?? he is only 5 months old. [/INST] Doctor:Hello and welcome to HCM,Bacterial infections like urinary tract infection (UTI) can cause low white blood cell count.Appropriate treatment of UTI is required with appropriate antibiotics.The white blood cell count will improve once the infection clears.Crohns disease is not known to affect the white blood cell counts directly so this is not a symptom of crohns disease.Thanks and take careDr Shailja Puri </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Does pinkish brown discharge indicate pregnancy? Patient:Hello I had sex two days before my period which was 6 wks ago & it came on but shorter than normal now I m 11 days late for my next period & my period usually comes on normal but now it s late. I took a pregnancy test but it showed negative. I just had this warm gush of pinkish/brown discharge. What do you think this could be? [/INST] Doctor:Hi dear, I have gone through your question and understand your concerns.Delayed periods can be due to pregnancy .Pink discharge or slight spotting is common in pregnancy.I would suggest you to get a urine pregnancy test done and get further management accordingly.Hope you found the answer helpful.Dr Deepti Verma </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest remedy for pain in abdomen near incision Patient:Its been three weeks since tah, Iv been feeling, ok, and my incision is ok, today I bent down alot, cleaning the tub, and now am in so much pain, its friday so I cant call my ob till monday for pain meds, am taking ibuprofen 400 mg, but its not working, just worried about the pain, am laying done, but hurts when I turn or get up too restroom. [/INST] Doctor:Take diclofenac or tramadol injection for the time bng.after that u can see the response n see.u can go for diclofenac tablet also if inj not available. </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 a lump on the head? Patient:Hi, My 2.5 year old fell backward while playing this afternoon and bumped the back of her head on our concrete porch. She did not fall from any sort of height. She was quickly comforted and went back to playing and her activity, appetite and mood have all been excellent since then. I was only a little worried about the lump on the back of her head -- not very big but a little squishy to the touch. It does not seem to bother her at all. Should I be concerned? Thank you. [/INST] Doctor:Hi, dear. I have gone through your question. I can understand your concern. You may have some hematoma formation most probably. No need to worry. Just keep observations for few days. If he has any symptoms then urgently go for CT scan . Otherwise its ok. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes sweating and shivering after a heavy meal? Patient:Hi everyone Before 2 hours. At 6 AM. ( i ate a heavy meal at 2 am ) I was walking outside for a short time like 5 minutes then all of a sudden felt tired, started shaking and sweating a little bit, tachycardia and nothing else. I couldn t stand so i went to my bed and it did t disappear for like 30 minutes , then i slept while shaking for 2 hours and i am feeling better right now. I didn t eat till now ( i can last for a day without eating and that did t happen ). I walk every day, run every day. I m 21, no health problem ( just atobic asthma), non of my relative is diabetic. ( no fever, loss of consiousness, stress or blurring of vision or chest pain ) i m not taking any medication. [/INST] Doctor:Hi thanks for using Healthcaremagic All your symptoms started after having heavy mealsThe possibilities for the symptoms are1.Reactive Hypoglycemia--after having heavy meals some persons develop Hypoglycemia .This is due to the overproduction of insulin in the body .The main culprit is insulin resistance.To overcome insulin resistance body produces more insulin and as a result patient feels lethargic2.During post Pandial time increased blood supply to the intestines occurs..As a result other body parts receives little less blood that time .this could be one reason..3.Activation Autonomic nervous system could be another reason...But you will have palpitation and dizziness...4.Indigestion also can cause these symptoms.thank you..... </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What is the thick cord near scrotum after inguinal hernia surgery? Patient:hi ,im mov va 22 years old ,one weak ago i had done indirect inguinal hernia surgey .the doctor said that the name of operation is darning operation he didn't use mesh repair . about 3 days after the operation i feels like thick cord in the scrotum in the right side i think its connected to testis but its thick unlike the left side im really worry about that !! plz help me about this [/INST] Doctor:Hello, Thanks for writing to us, I have studied your case with diligence.There is possibility of inflammation epididymis feeling like thicken cord on scrotum.Get clinical examination from your doctor.This can be reduced by medication like Trypsin chymotrypsin.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health.Take care </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What could sharp stabbing lung and chest pain suggest? Patient:HI, the right side of my chest has been hurting all day. Really sharp stabbing pains near my heart and lung. Followed by troubled breathing. I have asthma, and have been using my inhaler all day. The pain still persist. Not sure if I pulled a muscle or something minor. Just concerned. Any advice? [/INST] Doctor:Thanks for your question on Healthcare Magic.I can understand your concern.Sharp stabbing chest pain is mostly seen with musculoskeletal cause like pulled muscle.So avoid movements causing pain. Apply warm water pad on affected part of chest.Take painkiller and muscle relaxant drugs.You will mostly improve with all these in 2-3 days.Of chest pain still persist then consult doctor and get chest x ray and ecg to rule out lung and heart diseases.Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Q. Will Kalarchikai cure multiple ovarian cysts in PCOD? Patient:Hello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well. [/INST] Doctor:Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Reason for soreness in abdomen after hysteroscopy? Patient:I underwent Hysteroscopy 3 weeks ago for polyp removal. ever since then my abdomen is hurting me.its not pain but soreness and dull aches at random areas especially on either side of umblical.not getting a normal lighter abdominal feel. for first ten days , the abdomen wasnt even able to bear strain and minor stress,but that is almost subsided, burt deep soreness , aching is still there. [/INST] Doctor:Hi! Good evening. I am Dr Shareef answering your query. From your history, it seems that possibly you have got some kind of pelvic infection post hysteroscopy, and so the pain is persisting. If I were your doctor, I would advise you for an ultrasound of abdomen, a complete blood count, and possibly a vaginal swab for culture and sensitivity test. Further management would depend on the results of clinical examination of your abdomen, and the investigation reports.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. Wishing you an early recovery. Dr Shareef. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes high blood pressure inspite of taking Cozaar? Patient:I've been in a high stress situation for 2 days and my b.p. Has been as high as 180/116 and won't go below 155/98. I'm on 100 mg Cozaar and it normally doesn't exceed 135/85. Planning to call dr in the morning. Anything else I can do in the interim? [/INST] Doctor:Hi,Cozaar will take some time to act, if there is no chest pain, headache or shortness of breath, then there is not urgency of getting down bp. You monitor it thrice a day and if still remains high then need to add some more medicine usually Amlodipine. You can get this prescribed from local doctor. Also use some relaxation techniques like yoga and regular exercises to reduce stress. Also have low salt diet, healthy food. Get your lipid and sugars tested. Avoid smoking and alcohol if any.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Sagar Makode </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: How can a tooth abscess be treated? Patient:My question is regarding my mother having an abscess tooth. I had taken her to the dentist on 5/5, she had s script for clindamycin HCL 150 mgs called in. She has been taken this very 6-8 hrs as instructed. The infection has not changed. My mother is 87 years young and I oversee her medication to make sure she is taking it correctly. She has a very sensitive stomach so what should I do? [/INST] Doctor:Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. If your mother is having a tooth abscess then taking only antibiotics is not sufficient at times and the tooth needs to be treated.As your mother is taking antibiotics since long and there is no change in infection, so now the tooth should be either treated or removed.So my suggestion is to consult an Oral Physician and get evaluated and a clinical examination and investigation like x ray can help in confirmation of the condition of the tooth.If tooth can be saved and your mother is in a good physical and medical condition then root canal treatment can be done.If the tooth has a gross decay then extraction of the tooth is advisable.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Honey Arora </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest remedy for injury on tongue Patient:My 5 year old stuck her tongue to a Frozen pole and pulled it off, tearing the skin off the tip yesterday am. We used a washcloth to stop the bleeding and it is feeling better today however, when I picked her up from school today, it was patchy-white. The white went away when she ate a snack. Should I be concerned with infection and see a doctor? [/INST] Doctor:Hi,Thank you for asking question on health care magic.Injury to the tongue usually heals of its own.No treatment is necessary.Feed her with cold,sweet or bland foods so that she will not feel pain.Hope this answer will serve your purposePlease feel free to ask any more queries if requiredTake careDr.M.V.Subrahmanyam MD;DCHAssociate professor of pediatrics </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest treatment for costochronditis Patient:I was diagnosed with Erythema Annulare last August. Cause as of yet unknown! I now am suffering my second bout of Costochronditis in a month. Really frustrated that any of the doctors or consultants I have been to cannot find a cause/cure. Any recommendations/diagnosis? [/INST] Doctor:Thanks for your question on Health Care Magic. I can understand your concern. Costochondritis is inflammation of costal cartilage. It can be due to physical over activity, strain, trauma or viral infection. Irrespective of etiology, treatment remains same. You should avoid heavyweight lifting, strenuous exercise. Avoid movements causing pain. Apply warm water pad on affected site. Start painkiller and anti inflammatory drugs. Since these drugs are prescribed medicines, you need doctor 's prescription for them. No need to worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Can I continue giving Fenistil drops to infant as she is still having cold? Patient:Hello Doctor! my granddaughter is 11 months old. A week ago she had cold and the pharmacist prescribed her Fenistil drops. After 1 week, we stopped the medicine. Can I still used the left over fenistil now that she still have cold and I hear sounds of mucus when she breathes. [/INST] Doctor:Ur grandchild is suffering from upper respiratory infection, she also has a chest congestion and requires bronchodilators with antibiotics, u can give her kofarest syrup 2.5ml twice a day for 7days after food and Taxim-o dry syrup 2.5ml twice a day for 7 days after food.this will give her a good relief </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes constant pain in upper left abdomen? Patient:I have been having upper left abdominal pain for the past 11 months, it is not intense, but it is a constant pressure, burning and stinging pain, worse at night, same pain towards back too. I have notices a small lump on my lower ribs about 8 months ago and since then it has gotten bigger. It is hard and can not move, feels like a rib sticking out, about 2 - 3 cm big with round tip. Other symptoms are intense itching of legs and arms, comes and goes. Burning inside my body when drinking wine or alcohol, starts at neck and then spreads to arms and legs, lasts about 15 - 20 min. I am constantly tired, dizzy and have chills and hot flushes sometimes, can not eat a lot and have indigestion at night only when lying down. Have been to DR who at first treated me for muscle injury, then for gastric problems (Omaprozole), with no improvement. Has since been diagnosed with Costochondritis and has been on Naproxen for 3 weeks with no improvement. Blood work was normal, only slightly anemic. I also had a 2nd miscarriage 3 months ago at 11.6 weeks pregnant. (first miscarriage was 18 months ago at 8 weeks) I am 33 years old. Please can you advice. [/INST] Doctor:Hello,It looks at the case of gastric ulcer and irritable bowel syndrome (IBS). I would advise you the following:-Upper GI endoscopy-CT scan of the whole abdomen-Blood tests particularly thyroid, CBC. Sugar, liver, and kidney functions; amylase, and lipase. PI, Antacid, Domperidone, symptomatic, and supportive should help you. Continue the treatment for costochondritis.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. T Chandrakant </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Need treatment for tapping the fingers and feet Patient:I keep tapping my fingers and feet and snapping my fingers too and I wanted to know if there was some sort of diagnosis for this as it distracts me a lot from almost anything that I'm doing and I can barely keep from doing it for more than a couple of minutes. [/INST] Doctor:DearWe understand your concernsI went through your details. I suggest you not to worry much. These are habits and they are called mannerisms. Inn simple terms every human being carry some mannerisms. It is also seen that during lifetime, people change mannerisms easily and continue with the new one. Let me assure you, you not loosing concentration due to the mannerism but you are loosing concentration and therefore are aware of the mannerism.No body cares about their Mannerisms until thee mannerisms are not harmful to their profession and life. If this really gives you tough time with your job and life, then you should change it. The best method is to ask several friends to notify you whenever he notices your mannerism. Try this and come back.If you require more of my help in this aspect, Please post a direct question to me in this website. Make sure that you include every minute details possible. I shall prescribe some psychotherapy techniques which should help you cure your condition further.Hope this answers your query. Available for further clarifications.Good luck. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest treatment for temporomandibular joint disorder Patient:Hello, just recently I have been told I have tmj. With this my jaw has bothered me but its ok because the pain is not severe. Over the past few months my chest hurts when breathing but this happens every now and then. Just today I discovered that the top part of my gums are a very dark color and was thinking maybe that can be a reason why my face has been hurting me. Also within the past two weeks I have gotten really dizzy and feel like I need to puke. This may be nothing but is this something I should take a little more serious? [/INST] Doctor:TMJ dislocation or dysfunction is not very common like regular knee or back pain. Resting (Jaw movement) should be more than enough for little problem to resolve. However, if rest isn't solving the pain or dysfunction then you must get one X-Ray and consultation of Orthopaedician done.Meanwhile, avoid hard food to chew and speak minimal to give proper rest.'Shitali' pranayama/breathing can help to reduce excessive heat in mouth or chest region. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Q. Is it advisable to take Dopamine agonist after stopping Paliperidone for schizophrenia? Patient:Hello doctor, Ropinirole to boost dopamine after Paliperidone treatment for schizophrenia? I am a 46-year-old male. I have been in hospital a couple of times recently, in their judgment I was quite unwell (paranoid about spooks after certain events), diagnosed with schizophrenia (though I am not sure, although I was extremely paranoid), and they put me on a CTO for injections of Paliperidone, which I have been on for the last 18 months or so. 100mg I believe for 6 to 12 months, then 75 mg for six months, and now on the lowest dose that it comes in and have been completely free of thoughts of spooks for nine months, so I am well. But I notice that I seem to be a little zombified due to the effects of the drug, and am worried about Dopamine impact (an important chemical), and frankly, I would like to try to help restore Dopamine to a healthier level. I am not sure that is going to happen naturally, so was wondering about a low dose of a Dopamine agonist like Ripinirole for perhaps a year or so, to get things moving in the right direction. Whether this would actually help restore dopamine function though I am not sure. Also, it can increase the chance of psychosis, hence the preference for low dosage. What I am after then is some brief comment on whether you would recommend this or not (at a glance), or something else. Any comment would be appreciated. [/INST] Doctor:Hi. Taking Dopamine agonist to restore dopamine level in the brain after giving antipsychotics for schizophrenia is not a suitable choice because of relapse of psychotic symptoms or exacerbation of symptoms not only psychotic symptoms but mood symptoms, these side effects are called extrapyramidal symptoms which can be managed to give anticholinergic medications along with antipsychotics, better to visit your treating doctor to have healthy discussion on this. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest treatment for persistent fever Patient:My daughter is 6 years old and has been running a high temp for 3 day. So far the highest was 104.1. No other symptoms and she s acting herself and playing. I took her to doc. They said maybe coxsacki virus. I don t see anything on her hands or feet. Maybe one dot on her throat. Should I be concerned and take her to her regular doctor? [/INST] Doctor:At least it seems that she has a virus. You can keep giving her paracetamol for her fever and sponge her when her temperature crosses 101 F. Give her plenty of liquids and a light, easy to digest diet. If she breaks out into a rash elsewhere, or has new symptoms, take her to the doctor. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest best time and test to confirm pregnancy Patient:Good day, id like to ask regarding getting pregnancy. My last monthly period was december 2 and we had intercourse with my boyfriend last 16th of the month. My cycle is 30-31 days. Is there a possibility of getting pregnant? If possible to have pregnancy test when is the best day to have it? Need help. [/INST] Doctor:Hi ,Easiest way to calculate date of ovulation is subtract 14 from your usual duration of periods. I mean to say 30-14 = 16, so around 16th would be day of ovulation. Sperms stay alive for 3 days , so +/- 3days of 16 thday would have high chances of pregnancy.Pregnancy test is positive in urine from the next day of missed period. You can have confirmation by Serum Beta HCG. It can diagnose even the smallest of pregnancy.RegardsDr.Balakrishnan </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: How to cure sinus infection? Patient:I have been monitoring my BP at home and have found my left arm usually 10 - 20 degrees higher than my right...ie last evening 179/100 left 145/97 in the right...last week it showed in my left arm 198/120 with a pulse of 122 (I did speak with my doctor - and was diagnoised with a sinus infection [/INST] Doctor:Hi there and thank you for your question.I can appreciate that you may have a sinus infection if you complained of symptoms relating to this issue, but I highly doubt that this is what's causing your blood pressure to be so high.I would like to suggest that you physically consult with your doctor as your blood pressure is very high and seems to be persistent seeing that in the period of one week you had such high readings.It would be advisable to have this issue managed as soon as possible as complications such as stroke, cardiac failure and kidney related issues can arise from uncontrolled high blood pressures.It would also be wise to have both arms checked to see if there is a genuine difference between the pressures on both sides. A condition called dissection of the aorta needs to be excluded if there is a difference of greater than 20 %.I hope you can get medical attention soon please and good luck. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Q. Why does my 2 year old breathe as if he ran a marathon? Patient:Hello doctor,My 2 year old breathes as if he ran a marathon, coughs a lot and I hear a wheezing sound. [/INST] Doctor:Hello. If your 2 year old has breathing difficulty with infection, usually it represents pneumonia. I would like to know in detail: Since how long?Any history of fever?Past similar history?What investigations were done?A family history of asthma or allergy? May I suggest: Consult your specialist doctor, discuss with him or her and start taking the medicines with their consent. Follow up after two days. For more information consult a paediatrician online --> </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes sore ascending colon? Patient:Hi, thank you for taking my question. Im 59 years old man with a sore ascending colon. I went to the doctor not knowing it could be my colon but last week I figured out it must be. It hurt more when Im have a high sugar intake. Do you know what it could be? Thank you [/INST] Doctor:hi,thank you for providing the brief history of you.A Thorough clinical examination is advised.As per your history I do not think it is about soreness of the ascending colon. But to understand and sort out having a thorough clinical examination and laboratory tests we can come to a conclusion for the same if it is really a sore ascending colon.Also, your age is 59 having so physiological changes in the body is accepted and also doing regular physical exercise should help improve the metabolism.As ,you found sugar intake has led to aggregation of the symptom I advice you to undergo a thorough clinical examination and laboratory tests.Regards Jay Indravadan Patel </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: How to treat a white lump on the leg? Patient:Hi, I had about 6 months ago a spot on my leg that i thought was a bite or ingrowing hair. After squeezing quite a lot and getting nothing out of nit layers of dry skin kept building up, i did pick these at first but then decided to leave it to heal. It has now left a hard raised skin colour (creamy white) lump, what could this be [/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.Based on the facts of your query,You seem to suffer from-Sebaceous Cyst.Treatment- Conservative Antibiotic +Motrin Treatment x 5 days time.If no regression in the lump size-From Surgeon-by Excision of the Sebaceous Cyst.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: What is the treatment for liver cancer? Patient:My brothers father in law ( In Gaziabaad, India) is suffering from lever cancer in forth stage now . Jaundis is started last three days & his lungs / stomech is fulfill of water . He had treatment with appolp hospital & they get cemotherepy But i m not stissfied with them . Plz help me on very urgent basis. & tell me a doctor who will save his life. [/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.Unfortunately,there is no doctor in the world who can save his life since this is terminal stage of the disease and incurable. It may only be treated with palliative measures by pain supress and nutritional support,but prognosis is poor,very poor. I am sorry.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 swelling in the ankles and sleeplessness while on a CPAP machine? Patient:I have recently developed swollen ankles. I had open heart surgery about 10 years ago with great results, quad bypass. Also a cardiac stress test with (medicated) heart ultrasound about two months ago. Results were also good. Restarted compression stockings yesterday, didn t help much. Last night removed stockings, overnight most of swelling receeded. Wearing the stockings again today, and for the most part, swelling has returned. Very busy person, but in the evening when i have time, watching TV with feet elevated above heart. Will try sleeping again with stockings removed. I am also on a CPAP maching. Have not been gettinc adequate sleep lately. Going for sleep therapy session(s)starting this Friday at Henry Ford Hospital in West Bloomfield Michigan. Should I be concerned? Are there are other possible problems which may have excasperated the problem? Thank you. PS, my BP is averaging about 140/75, pulse stable at about 55bpm.. HDL AND LDL are under control with meds. [/INST] Doctor:Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. One of the reasons for swelling in the legs may be due to your hypertension medications especially if you are taking calcium channel blockers like Amlodipine or Nifedipine. Talk to your doctor and see if the medications have to be changed. Consult your cardiologist and get your heart checked with ECG, ECHO, TMT etc. Get blood tests done. See if your kidney is working well with renal function tests like- urea, creatinine. Seek emergency medical care if you have leg swelling and any of the following signs or symptoms, which may indicate a blood clot in your lungs or a serious heart condition: i. Chest pain ii. Difficulty breathing iii. Shortness of breath with exertion or lying flat in bed iv. Fainting or dizziness v. Coughing blood Certain medical conditions can also result in a swollen ankle or leg. These include: i. being overweight ii. venous insufficiency, in which problems with valves of the veins prevents blood from flowing back to the heart iii. rheumatoid arthritis iv. blood clots in the leg v. heart failure vi. kidney failure vii. leg infection viii. liver failure ix. lymphedema, or swelling caused by a blockage in the lymphatic system x. previous surgery, such as pelvic, hip, knee, ankle, or foot surgery To treat a swollen ankle or leg at home, remember the acronym RICE: i. Rest. Stay off your ankle or leg until you can get to the doctor or until the swelling goes away. ii. Ice. Put ice on the swollen area as soon as you can for 15 to 20 minutes. Then repeat every three to four hours. iii. Compression. Wrap your ankle or leg snugly, but be sure not to cut off circulation. Support stockings may be an option. iv. Elevation. Raise your ankle or leg above your heart (or as far above your heart as possible). Two pillows will usually give you the correct elevation. This encourages fluid to move away from your leg. Regards Dr Sanjay Kini </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest treatment for knee pain and allergy to medicines Patient:Hi I have lower leg pain just below the knee it is not the acl in the knee it is below that. I have a huge bulging blood vessel with bluing color not black and blue it is dark blue from the vein. I have all sorts of allergic reaction to drugs I take none at all I have high colestrol but can not take statins I had anaphylactic shock 5 times. I have changed my diet to fruits vegetable and fish and chicken I am on a diet of 1200 calories a day. I am 55 weigh 175 5 8 my job is active outside and inside. I swim but can not do as long as this pain is in my leg I actually can not walk on it either I have poison Ivy [/INST] Doctor:Hello,Generally, big blue vessels are varicose veins. Sometimes they ache locally. Often there is poor circulation and swelling in the limb out from where the varicose veins are.Allergy to one thing does not apply to unrelated things. Statins might all be related to each other but they would not be related to for example chicken. Other drugs for circulation or pain are likewise not statins. Lifestyle and really low fat, low sugar diets lower cholesterol, but the lifestyle actually has a better track record than the drugs for lowering health problems.Pain below the leg if there is swelling in the leg would imply circulation. This is mostly due to small clots and small problems BUT could be from LARGE clots which are a large problem and if the LARGE clot breaks loose and goes to the lung it can kill you. A reason to have it examined.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 could lumps on lips suggest? Patient:Hi, I have a lump in my bottom lip that has been there for over a month now. It started as a clear zit, which I popped. It then came back as a big whitehead, and now is a prominent lump on the inside of my lip. Should I be concerned? It doesnt hurt but is somewhat in the way, I am always tonguing it, not incredibly big but noticeable [/INST] Doctor:Hi dear ,The symptoms you mention in query are probably due to Fordyce spots . They are variant of sebaceous gland . These harmless small white bumps inside the lips are visible sebaceous or oil-producing glands. There are many treatment options available for such lumps like Electro desiccation , Pulsed dye lasers and Micro-punch technique . I would suggest you to consult dermatologist for proper diagnosis and rule out conditions like oral thrush , herpes simplex or a canker sore . For now apply lip balm containing SPF 15 and apply raw honey at night .Hope your query is solved.Get Well Soon.Best wishes,Dr. Harry Maheshwari </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Sudden swelling all around face. Diagnosed as nephrotic. On medicines. Responding to steroids. Prognosis? Patient:sir, my sis 35y/married presented with h/o sudden onset sewelling all around face, body 7-8 days duration a/w oliguria ,past his.h/o sore throat infection 2wks back, no other any significant personel n family his, work up done by urologist , shows urine re protein 4plus, ASO titer slight raised, usg kidney N, renal fn within normal limit.diagnosed as nephrotic syn Rx getting prdnisolone 60 mg, lasix 40mg TDS, augmentin 625mg BD.she is responding on steroid.seeeking for further evaluation by ephrologist n further management at varanasi. what is prognosis? [/INST] Doctor:Hi, welcome to HCM. You are one of the rare few who has provided all the important details! I suspect you are a healthcare worker yourself. You are right in that your sister needs to see a nephrologist (not urologist) ASAP. She needs to have a 24hour urine protein estimation and possibly a renal biopsy for diagnosis. The two differential diagnosis here are IgA Nephropathy and Post Infectious Glomerulonephritis. Only a biopsy can differentiate the two or clarify if the problem is something totally different. I am very wary of doctors treating emperically with steroids without proper diagnosis. We can prognostigate only if we have a biopsy confirmed result. However if the protenuria has settled already, we are in a dilema whether to biopsy or not?? Dont waste time and see a nephrologist pronto. I dont know who is near you at Varanasi, you will have to find out. Feel free to come back with any more quiries. Best wishes. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes red, swollen knees with horse fly bite? Patient:hello I brought my 4yr old to the nature center and I had gotten a horse fly bite I noticed a bite behind his knee there is a red dot with swelling and redness across the back of his knee how can I tell if it is an allergic reaction or if it is something I should worry about and also what can I do to treat the affected area safely [/INST] Doctor:Hello. I just read through your question. Generally, any reaction to a bug bite, big or small, can be considered an allergic reaction. Redness and swelling to the area of a bite is expected. Cool compresses to the area typically help. They resolve on their own after a few days. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Does muscle/joint pain in many body parts, sudden pain in knee happen after complete hysterectomy ? Patient:I had a complete hysterectomy in October.....I am 59.....since January, I have muscle /joint pain in many body parts....sudden pain in my knee lead to a dx of 2 torn menisci.......and surgery in March....as I recover from that my fingers, wrists, hips lower back are aching and I m told arthritis. I have been very depressed over hurting all the time and feeling like I am 89. I had an angioplasty a few years back, so doctors don t recommend anti-inflammatories/advil, or hormones......I ve been at a loss. I came across an article today menopausal arthralgia for the first time today, and I am now wondering if this is what is going on with me, as the last six months I feel like I aged 20 years. [/INST] Doctor:hifor joint pains,tylenol can be taken without harm for angioplasty.Do hot fomentation of joints and you may apply anti-inflammatory gels easily on the joints two three times daily, rubbing it gently.Hysterectomy has nothing to do with this arthalgia,however if ovaries are removed, there can be some hormonal imbalance. Get serum calcium and vitamin D levels checked also,besides CRP, ESR,TLC, DLC blood counts.best wishes </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: MRI of brain done, high resolution flair, diffusion, calcified granuloma, normal sulci and fissures. What does this indicate? Patient:sir one of my relative aged 30 years got fit few days back and on the recommendation of doctor got MRI Brain (E.P.) Report is as follows:MR imaging of the brain was performed and high resolution FLAIR, Diffusion. T1 and T2 weighted sections were obtained in the sagittal, coronal and axial planes.The study reveals a hypointense focus on all sequences in right temporal region suggestive of calcified granuloma. No perilesional edema is seen.Rest of the creberal parenchymal appear normal. The lateral, third and fourth ventricles are normal is size, shape and position. The cerebellum, brainstem & pituitary gland are normalBasal cistems, sulci and fissures are normal. 7th & 8th nerve complexes is seen.No abnormal vascular loop is seen around the brainstemADVISED: Further evaluation...........Please correlate clinically.........Recommended Treatment:Levesam (500mg) twice a day atleast for three yearsPlease let me know:Can he drive two wheeler or four wheeler as he is a marketing managercan he take drink or eat non-veg, although doctor advised to avoid itcan he play games/sports like swimming, cricket etc..what diet should be taken can he enjoy married life as he is married and having a daughter [/INST] Doctor:Hi,Your relative had seizure (fits) secondary to R) temporal calcified granulomaHe need to continue the same medicine as plannedHe should avoid driving for next 1 month after the onset of fits because 5o% recur within one month while on medicinesHe can have normal diet (mixed).he should not drink as it precipitates seizureHe can play games and other sports except swimming for next 1months, during swimming for subsequent months some one should monitor himYes he can enjoy married life.Precautions to be taken are avoid fasting , sleep deprivation and drinking alcoholHope this will help youRegards Dr Sandhya ManorenjNeurologistHi tech city Hyderabad </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: Q. I masturbate only by rubbing the tip of the penis. Is it a wrong way? Patient:Hi doctor, During masturbation I just rub the tip of the penis and not the entire penis. Is it a wrong way of doing? I do not get excited during sex and unable to ejaculate. Only, rubbing the tip of the penis gives me excitement. Also, two weeks ago, I have undergone circumcision as my foreskin did not retract. Before circumcision too, I have the same problem. Please help. [/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: What causes pain in knee area? Patient:My problem started with pain from the top of my thigh to my knee. Now the pain is concentrated in my knee area. I can t sleep on my side as the pain really intensifies then. I can sleep in a recliner with little pain. But if I am on my leg too long it starts to pain. I have been taking Aleve for a week and the pain still persists. Have had an x-ray and blood work and nothing has shown up. Any advice or ideas as to what this is? [/INST] Doctor:Meet a orthopaedician get examination of ur knee done and later furthur mri or other investigations if needed to diagnose your knee problem With just your short history diagnosis is difficult </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes gall stones? Patient:Can gallstones develop as a result of another condition such as a large kidney stone. Neighbor was diagnosed a month or so ago, but had to wait a for lithotripsy. Had nausea & vomiting, which she still has, in addition to pain. Her skin looks yellowish. [/INST] Doctor:Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. Kidney stones and gallbladder stones are entirely different and they are formed by different mechanism. Gallbladder stones are of two types biz cholesterol stones and pigment stones. High blood cholesterol and sedentary lifestyles may predispose to fall stones. People with increased turnover of red blood cells are also at a higher risk of developing gallbladder stone. However most gallbladder stones are regarded as idiopathic without a particular cause. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest treatment for severe numbness on the thigh Patient:Hello, i recently went to the Er this past sunday and recieved a shot in my upper left thigh of muscle relaxer. Well something was not right after my shot. Immediately my thigh started getting numb above the shot area. It is completely numb above my knee. What could this be? And is this normal. I still have it and its going on 3 days. I am worried. [/INST] Doctor:hi i appreciate your concern.as per your description,i learn that some medicinal injection was given in muscle of ur thigh.developing numbness shows that nerve suppling that muscle is affecting ?probably due to chemical in inj.it is advisable to consult your neurophysician at the earliest to find out type and nature ,extent of damage if any.thanks.i will be happy to answer further quary. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What could cause swelling of leg,redness and tingling sensation? Patient:I was in jamacia7 years ago and noticed my leg was swollen three days before leaving I never felt a bite and don t know how I got it . Everytime I took a shower my leg would turn red and some times tingle. I noticed it about a two years ago with out having a shower,it has spread on both legs and on the scrowdem ,it has become very irritable and sore and numbing. I have tried lamisil cream i have also used taro-clobetasol cream and moisturizing cream without any success . I have seen a dermatologist. [/INST] Doctor:Hello and welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. Usually this is a fungal infection you got there. Such infections may take time for treatment even if you didn't see or feel them. From your given history they are spreading and you only tried topical or external ointments. Usually they give dramatic results fast, if not you may increase your showers, always use clean towels to dry your body, try to take care of personal hygiene and avoid infections from any possible person. These infections usually happen with athletics. Anyway using anti-fungal shampoos and taking care of your personal hygiene may be enough in some cases. Use sysemic antifungals (fluconazole) in addition to the topical ointments or sprays available. Both acting simultaneously will be more than enough to eradicate such infections. Selsun blue shampoo is recommended. Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Ahmed Aly Hassan </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: How long should i wait to take other pregnancy tests? Patient:My first day of last periods was 30 June and I usually have 28 days cycle I ovulated possibly on 16th night but had unprotected on 17th morning Took levonelle on 19th noon and a bit worried coz I did nt had my periods which should have been due on 28th July I took two home tests which shows negative But I m feeling a bit bloated How long should I wait to take other test [/INST] Doctor:Hi,I have understood your concern. I will suggest you the best possible treatment options. 1 ) First of of all do not panic. 2 ) I will suggest you to wait till 15 to 20 days after your episode of unprotected sex act. If you Still happen to cross your dates, then please get morning's first sample of urine tested for pregnancy. In case of doubt blood beta HCG test and USG will be of help. 3 ) If you are pregnant, you can opt to continue with the pregnancy or if you want to terminate the pregnancy, then you can opt for termination of the pregnancy with medicines safely till 9 weeks of pregnancy under medical supervision. 4 ) If your pregnancy test is negative, then you can simply wait for the onset of periods or induce the periods with progesterone tablets.Your treating doctor can guide you further about the doses and withdrawal bleeding of the same. I hope this answer helps you. Let me know if I can assist you further.Thanks,Dr. Purushottam Neurgaonkar </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest treatment for multiple gall stones Patient:Hi , I have been suffering with severe chest pain, feeling nausea , getting hot flushes,some back ache, was seen by cardoalogist he suggested an angiogram. however in the interima scan was done and was found that I have multiple gall stone about 2cm. suggested that i remove my gallbladder what is your suggestion [/INST] Doctor:hi.thank you for posting query at HCM.Gallstones are small stones that form inside the gallbladder.Gallstones pain (Biliary colic) usually is usually experienced when the gallbladder contracts in response to a fatty meal. This compresses the stones, blocking the opening. As the gallbladder relaxes several hours after the meal, the pain subsides.1. Medical therapy is an option for gallstones , though a vast number of surgeons around the globe prefer removal of gall bladder- surgical intervention. Medical therapy includes intake of ursodeoxyholic acid ( UDCA) for a period of 12 to 24 months. UDCA has been shown to inhibit biliary secretion of cholesterol, reduce intestinal absorption of cholesterol, increase hepatic bile secretion, and improve gallbladder emptying. Medical therapy is useful if mild symptoms, stones are smaller in size ( weight reduction and low-fat diet is also a part of medical therapy.2. Surgery lasts for less than one hour ( usually half an hour). Laparoscopic surgery has greatly reduced surgery time duration and surgical complications. You may travel 7 to 10 days after surgery, though the surgeon may indicate precise time.I would also like to mention that gall bladder is removed completely in surgical intervention which may impair fat digestion. You maybe asked to cut fat completely from your diet ( or keep to minimum) after gall bladder surgery.hope to answer your concern.wish you good and sound health.regardsDr Tayyab Malik </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Is unwanted 72 effective in avoiding pregnancy? Patient:Hii.. I ve protected sex but in between condom broke down. she has period on 27th and we had sex on 10th., thing is i heard that sex on 14th day leads to pregnant as egg fertilize on that day.. after having sex she had unwanted 72 within 1 hrs.. is it safe and sure that she wont be getting pregnant. one more thing is she has consult gyno doc for some other reason will doctor get to know that she has sex or something... [/INST] Doctor:Hi, thanks for writing..Yes, unwanted 72 reduces the chance of pregnancy to 89% if taken within 72 hrs of unprotected intercourse... The common side effects associated with it s delayed periods and intermenstrual spotting.. Many people get withdrawal bleeding within 1 week of taking the pill.. Repeated use is not recommended due to side effects.. Hope I have answered your query.. Good day </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Alternate medicine of loestrin because of the side effects? Patient:My 19 year daughter was changed from Loestrin 24 fe to Minestrin 24 fe in December. She in on the 2nd pack and now having terrible breast tenderness/tingling, bloating, mood swings and an episode of nausea and fainting last week. She doesn't get a period on this loestrin and so far has not had one on Minestrin but she was concerned and took a pregnancy test yesterday morning and again this morning. Both were negative. I have read these side effects are common on this BCP. Should she be taking something else? [/INST] Doctor:**1. Loestrin® 24 Fe [ norethindrone acetate and ethinyl estradiol and ferrous sulfate] is a prescription oral contraceptive used for the prevention of pregnancy and apart from the side effects you have mentioned other noticeable are Vaginal bleeding between periods (spotting) or missed/irregular periods may occur. [reason for going for pregnancy test]2. For additional safety information, or before opting for any alternate medicine please see FDA-Approved Patient Labeling. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes ankle pain and tingling sensation in the toes? Patient:When I rotate my ankle there is slight pain. when I rub my foot I get tingling sensation in my toes. Ankle pops every now and then. It this cause of concern? I don t remember twisting my ankle in any way. This is only happening with the left foot. [/INST] Doctor:Hi...Your ankle pain and tingling sensation is due to some minor impingement of muscle and nerve around ankle....this could have happened in a previous episode of ankle twist or following an ankle injury....or walking in a uneven surface...I recommend you to kindly Do..Lot of icing in the painful area...Ankle stability exercises...and strengthening...likepushing a sand bag towards the other leg...pushing the sand bag towards outwards..away from your body...keeping a sand bag on your toes and lifting your toes up and down...Single leg calf raises..Standing on a single leg with eyes closed...Stretch your calf muscles. .gluteus..frequently...Wear a well cushioned for wear...Hope this is helpful for you..Revert back in case you need anymore clarification. . </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What does tiny bumps in the form of patch indicate? Patient:My 5yr old has a circular patch on his face that was once raised. It has gone down but the round patch is still there. Its been over 2 months and now there are very tiny bumps are starting to form in the patch. What could it be.? The bumps are not red or itchy. They seen to be increasing in the patch. [/INST] Doctor:These bumps could be due to a virus, an allergy, an infection or due to no underlying cause. The best way to resolve this is to show him to a dermatologist (skin specialist), or at least share 3-4 pictures of the bumps and patch to a skin specialist in this website through a paid question.Dr. Taher </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Q. After laser treatment of penile papules, my penis has become dark. Is it normal? Patient:Hi doctor, I am 24 years old. I had pearly papules on my glans penis a long time ago. I got them removed three months ago by a dermatologist with CO2 laser. Now, bottom of the glans penis is very dark purple in color. I have tried to put some gels on it, but had no success with that. I will attach the picture of my glans. Is this normal? Please tell me your professional opinion. [/INST] Doctor:Hi. I have gone through the attached picture and provided details (attachment removed to protect patient identity). For further information consult a urologist online --> </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: When he pee it started to bleed, please suggest Patient:my boy friend just pee n there was little blood in his pee what do that means no we didn't just have sex it been days it just happen out of no were [/INST] Doctor:1. blood in urine (hematuria) means there is problem in the urinary tract, which has allowed blood to get pass into urine. 2. a number of condition can lead to this passage including: .Urinary Tract Infection, Kidney Infection (pyelo nephritis), bladder (cystits) or kidney stone, enlarged prostate, Strenous exercises. 3. you have not mentioned about any associated feature along with blood in urine that whether it was painful or painless, or was there pain and burning during micturation and odor of the urine? 4. Younger men are more prone to kidney stone or hereditary nephritis (Alprot's syndrome). 5. make an appointment with your doctor regarding Urine examination and Ultrasound Abdomen 6. as him to drink plenty of water, amla, pomegranate, drum stick,bitter gourd,green banana. 7. treatment directed will be to the underlying cause, so check with your Physician. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Will Valium taken half hour before seeing dentist take effect? Patient:Good evening. I am going to the dentist in the morning and I am a dental coward :( I have to drive myself, so I plan to arrive a half-hour early and take a valium when I get there. Is that enough time for it to take effect? If it is not working, can I take a second one?The other question is, I will them have to drive myself to work afterwards. How long do I have to wait after taking it to be able to drive safely? [/INST] Doctor:Hi, as you say, if you have to drive and work, after manipulation, you better avoid the second dose, You will be given local anaesthesia, so you wont find any pain, during or after the process. It will work atleast for few hours, so you can safely go to driving and to the work. Thank you. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Q. How to get some relief from throat congestion and irritation? Patient:Hi doctor,I am suffering from cough, irritation in throat and mild pain. I feel feverish, but do not have a real fever. Temperature variation is a problem where I live and I travel around 50 km daily by bus. I am also a smoker. During season change, I usually get into this trouble at least twice a year. Earlier, I have been prescribed to take Azithromycin, Levocet and Paracetamol 650. Should I follow the same prescription? I cannot afford to be resting for a few days. I teach at a college and we have examinations going on. A cough is not severe but would be good to have some relief. Is there any cough candy? I am already making some plans to quit smoking. Apart from quitting smoking, what lifestyle changes or long-term medication I can use to avoid these troubles? [/INST] Doctor:Hello. It is again an episode of upper respiratory tract infection. The prescription would be the same. You try first Azithromycin once a day for five days. If it does not respond, then I suggest Amoxicillin. Along with this, I suggest Betadine gargles and syrup Alex (Dextromethorphan, Guaifenesin and Phenylephrine) two tablespoons whenever on needed basis. Consult your doctor, discuss with him or her and take the medicine with consent. You need to be careful regarding cold weather and food items, because whenever one consumes cold item or cold air goes inside there is multiplication or growth of microorganisms leading to infection and symptoms. So, avoid this thing. Also, smoking hampers local immunity so that must be stopped. You must be getting some symptoms like throat congestion and irritation. At this stage, you should do Betadine gargles to kill those excess microorganisms in the throat before setting infection. For further information consult an internal medicine physician online --> </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What does high liver function on ultrasound refer to? Patient:MY 12 yr old son has to have more blood work and a ultra sound because his liver function is high is what i was told. This is the 3rd time he has has blood drawn as they diagnosed him a month ago. I am concerned and do not understand what would cause this. From what I am reading on here it does not look good. Thank you concerned Mom [/INST] Doctor:HelloIt is important to know individual parameters of liver function test like bilirubin level(direct and indirect),SGPT,SGOT,Alkaline phosphatase etc.Increased liver function tests may be due to many reasons like hapatitis,drug induced,metabolic disorder,autoimmune causes etc.Besides this,your son need proper clinical evaluation and further investigations like ultrasound of abdomen.Biopsy of liver tissue is advised in selected cases.It can tell exact pathology.Treatment depend upon findings.Get well soon.Take CareDr.Indu Bhushan </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes severe mid-lower back pain while sitting, and especially while standing? Patient:I have severe mid lower back pain that is worse when standing 8/10 and 2/10 when sitting . I did have prostate cancer and received radiation and implantable seeds for treatment in 2015. I also had bilateral hip replacements in 2014,for severe arthritis.Any thoughts? [/INST] Doctor:Hi i am Dr Ahmed Aly thanks for using healthcaremagic site ,I had gone through your question and understand your concerns .. In my opinion that might be sciatica due to nerve compression which is common for post operative hip replacement patients . You may begin with relaxation , advil tab when needed , hot massages with topical gels , some cases may need steroid injections , physiotherapy will be effective . Please consider a 5 star rating with some positive feedback if the information was helpful. Wish you good health,Any further clarifications feel free to ask. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest treatment for large sores on one side of buttock? Patient:Sure, my sister has large sores on one side of her but, she has had major hip surgery and is not recovering very well, the doctor gave her a medication for shingles, they are a lot larger and are raised around the edges and spreading, makes her feel bad and itches very bad? Any suggestions? [/INST] Doctor:Hi,It seems that she might be having non healing wound with super added fungal infection.Go for proper cleaning and removing debris and then dressing with triple acting cream.It is better to do dressing by doctor only.Keep wound and site dry, clean and airy.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: How to manage swelling in face, an allergic reaction to acne cream? Patient:Hello doctor I used a acne cream on my face which contains sasylic acid and benzyol peroxide my face had an allergic reacation all swollen and puffy a cool ice packs helps but i think i need something else also i put benadryl cream and have taken a whole bottle of childrens benadryl can u help me [/INST] Doctor:Thank you for your question!One of the side effects of salisylic acid and benzyol peroxide is skin rash. It is an allergic reaction occurs in some people. You have to avoid the cream, it may give still serious adverse effects with continuous use.Cool ice packs may help you to some extent to decrease inflammation. Topical application of benadryl cream also helpful. Avoid excesss amounts of benadryl tablets. In addition, Use cetrizine tablets twice daily for 10 days.Avoid dust and don't expose to sunlight. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest treatment for exfoliation Patient:An 68 year old female, diagnosed to have gouty arthritis 3 months ago came to the OPD with history of dry scales all over the body since 3 weeks. There was history of fever with chills. She started exfoliating profusely, initially trunk and buttocks, gradually progressed and involved face, back and lower extremities. There was no history of evanescent skin lesions, weakness, joint pains or history of red eyes. There was no history of jaundice vomiting or abdominal pain. Systemic review of symptoms was within normal limits. On examination patient was ill looking. There was no pallor, jaundice, clubbing or lymphadenopathy. Systemic examination was normal. On skin examination, there were dry scales involving trunk, buttocks, face, back and lower extremities involving more than 90% body surface area. Skin was shiny, thickened and erythematous. Scalp skin also showed exfoliation. Hair and mucous membranes were normal.What is the most probable diagnosis on her? [/INST] Doctor:Hello,I can understand your concern for exfoliation of skin. Kindly check for the exact reason for exfoliation as it can be due to varied reasons. In my patients I combine Petroleum and other oils as emollients and urea as keratolytic cream.Petrolatum and other oils are available over the counter easily. I suggest my patients to apply any of these just after bathing when the skin is still wet. It preserves the moisture in the body and therefore reduces flaking. On applying any of the creams later you should first give compressions of mildly warm water of can take a shower and then apply it. Do not use any strong soap or detergents over skin. Wear simple lose cotton clothes and avoid synthetic clothes.All the best. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: How to treat a lump in the lower abdomen area? Patient:Hi, may I answer your health queries right now ? Please type your query here...I gave birth to my second child almost exactly a year ago, and I notice a strange lump in my lower abdomen when I lay down on my back. Its not noticeable when I stand upright, but very much so when I lay down. Dont know what it could be? [/INST] Doctor:Hi,Dear,Thanks for the query to HCM.I went through your query and understood your health concerns.In My opinion-Currently-you may be having some lump which needs clinical check up from a doctor.As your information is very limited, its really difficult to comment and reply the reason and treatment of that lump.Advise on Remedy--Emprically I feel,You should consult ER Obst/Gynaec doctor who would do USG /Xray abomen after abdominal check up and would treat it accordingly.Wellcome for further query to HCM in this regard.Wishing you fast recovery. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Q. What medicine can be used for allergic reaction to dust? Patient:Hello doctor, I am allergic to dust. I have a doubt that I have a seasonal allergic rhinitis and I have been using anti-histamine and still it is not working for me. My anti-histamine is Telfast 180 mg. I am using it for the past one month because I have been sneezing. My nose is dropping watery colored liquid and my nostril is so itchy. Can you give me some advice and medication what to use? [/INST] Doctor:Hello. I suggest you investigate with AEC (absolute eosinophil count) testing so that further comment can be given. If AEC is much high, Hetrazan can be prescribed. For allergy inflammation, Fexofenadine plus Montelukast combination can be prescribed. Moreover, for rhinitis, Azelestin or Fluticasone nasal spray can be prescribed to use for 3 to 5 days. Steam inhalation done three times a day with lukewarm water will be beneficial. I would like to suggest you consult an otorhinolaryngologist for detailed evaluation as rhinitis is there for one month. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: How to treat heel infection caused by an injury? Patient:my friend came to visit from alaska where he injured his foot and the back of his heel appears to be infected and he says after 6 weeks it got worse while hiking through the airport. he is near 60 years old and we would like to know a good plan of action until we can get in to see a doctor ? [/INST] Doctor:Hello and Welcome to ‘Ask A Doctor’ service.I have reviewed your query and here is my advice.In my opinion, you need to see a doctor as soon as possible.If any pus is there, it needs to be drained. 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: What is the treatment for phlegm in the nose and chest? Patient:On Thursday morning I started with a sore throat that got progressively worse all day. By night I had 101 fever, a running nose and the throat was so painful I couldn t speak. I treated myself with Alkazelter Plus (which usually dries me up) and Nasacort (which usually alleviates sore throats cause by my allergies) and Advil for fever and aches. By yesterday morning the sore throat was gone, but replaced by thick phlegm in my nose and chest. The fever was gone. Since yesterday morning I have been treating with Musinex, hot compresses over Vicks vapor rub on my chest and bed rest. My phlegm is yellow & darkish green, from nose and chest and is so hard to bring up that I ve irritated my throat again. I don t want to take antibiotics if I don t need to. What do I have and what should I take? [/INST] Doctor:Hi, I understand your concern. You had self treated your symptoms of allergic sinusitis with lower respiratory tract infection with the usual drugs you take. But it seems it was a severe allergic episode this time,which was secondarily infected by bacterias/viruses. The occurrence of fever/thick green phlegm indicate deeper lung involvement. and in such condition you do need antibiotic . Ideally antibiotic is selected after physical examination, blood counts & sputum culture & sensitivity test( if needful). If you are raely taking antibiotics- you can try with- Tab Azithral 400 mg twice a day, along with tab. levocetrizine at bed time& cough syrup containing bromexin. For minimum 5 days. the duration of medication & antibiotics are better selected after assessing physical condition. So I would advise for consulting your doctor before you start with medicines. With it you can continue with rest, hot saline gargles, vicks vapor inhalation, light nourishing food, avoiding allergens / cold/sour eatables. Thanks. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes lump near the ear lobe? Patient:Hi Doctor, I have a small bump in front of my right ear, about 3 mm away from the ear, next to the ear lobe. It s not visible, however, I can feel it when I press on my face near it. I am a little worried about it. I suffer from a mild hipochondria, and I can find myslelf searching all the time for other lymph nodes. I read a lot about lymphoma and I constantly make myself believe that I have it. Additionally, I had an ear ache about three weeks ago. I am also diagnosed with a chronic adenoids infection. About a month ago I felt a small lymph node on the left side of my neck. I had an ultrasound done on this lymph node and the doctor said it is nothing serious and I should not worry about it. Now I can feel two lymph nodes: the one on my neck and one next to my ear ( I suppose this one is also a lymph node). Do I have any reasons to worry ? Should I do an ultrasound of the ear lymph node as well? [/INST] Doctor:Hi, this is a small solitary lymph node and not to worry about this as this is a common thing and causes are dandruff, ear, nose or throat infections but could also be tuberculosis!please go for an FNAC test and revert back to us!all the best........ </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest treatment for patches of dry skin on face Patient:hi im having a problem with dry flakey skin and brusing. i had scabies about 2 months ago. and i dont have that type of itching but i do know i have something. i have patches or dry skin on my face i can not get rid of i also have itchy patches on the wrist and on the inside of my elbow and my legs. please help [/INST] Doctor:i dont know either u are treated completely or not but the site u are saying about looks like scabies it might be reinfection so plz take proper scabies treatment and also treat the household contacts the post scabies itching might persist for 15 days </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Whom should I contact as I need to donate my kidney ? Patient:WANT TO DONATE KIDNEY TO ANY NEEDY PERSON MY BLOOD GROUP IS A+ AM 44YEARS,5.9FT,82KG,AM HEALTHY [/INST] Doctor:Hi Welcome to HealthcareMagic. It is very noble of you to take such a decision.It is needed for more Donors to come forward.I advise you search in our experts database of Doctor for a Nephrologist near your area and approach him.You will have to be evaluated for routine screening of few disease and further procedure can be explained by Nephrologist. Take care and Good luck. </s>