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<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest treatment for panic attacks along with numbness in the arm Patient:I have been experiencing panic attacks with an extreme hot on the back of my neck, without fever and my left lower arm and hand go numb and tingling. I have very racey heart rate as well. This is happening far more often than normal. Sometimes I get these more than once a day [/INST] Doctor:Hello,Panic attacks are always due to underlying anxiety disorder. You should get treatment for anxiety disorder first. Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. K. V. Anand </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What home remedies can one follow to increase child's appetite ? Patient:heelo sir my son is 3yr n 9 months old he had stomach infection last month n again last week too. now a days his apetite is becoming very low he is not eating properly.his weight also didnt increasd from last 6 months he is 13.8 kg.as he is active but the prblem is not having food rice chapti at al.pl advise some home remedies. n hw to increase his apetite. [/INST] Doctor:winking water should be welcome to healthcaremagic please check on the drinking water and cleanliness avoid any out side food recurrent stomach infection may be due to some contamination better consult paediatrician and get your baby checked up and follow advice no weight gain in last 6 monyhs is matter of concern and cause should be found out and proper treatment started if required small frequent feeds may help by any means food intake must be increased </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest ways to maintain erection Patient:if arteries are partly blocked and prevents regular bllod flow to the penis...hence unable to maintain an erecdtion......can eating more healthy and exercise help restore normal function ? also if you masterbate too often can this effect and cause problems ? [/INST] Doctor:Hello,It may be due to performance anxiety. For that you may require testosterone level, lipid profile, electrocardiogram after physician consultation. Along with that avoid stress. Take proper rest and balanced diet. Till then you can take tablet sildenafil one hour before sexual act Hope I have answered your query. Let me know if I can assist you further. Regards, Dr Shyam Kale Family and general physician </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes pimples during hot weather in a 5 years old? Patient:dear doctor, in hot and humid weather my 5 year old get some sort of pimples here and there on her body....i hv put her on homeopathy and also put spirit on it which prevents pimple from growing further....shown her to her paeditrician who saying she just has sensitive skin and hasnt given her medicine...homeopathy is specifically for staphlococci bacteria.....doctor feels i dnt need a blood test....will the problem go away in a few days with homeopathy and spirit application...i worry abt extreme situations like bacteia contaminating blood etc....am i just overdoing it as she absolutely fine and no fever or discomfort....she tuchwud fine and just sweats a lot due to humidity.....pl tell is this common in kids and any cause to worry...hope nothing infects blood as no major medication gvn by doctor [/INST] Doctor:Hi,Is she having fever? How are the lesions- itchy / fluid filled / pus filled? It was helpful if you can send us a picture. In hot and humid climate, most likely this is milia- small pimples over the skin due to clogging and blockage of sweat glands. In absence of secondary infection (painful / edematous / pus filled), this does not require any specific treatment other than avoiding direct sunlight and keeping the skin cool with wet moping 3-4 times a day(apart from routine bath). If itchy, I used to give calamine lotion and antihistamine like levocetirizine for few days. In short, if she is not febrile and the lesions are not with surrounding edema / pain / tenderness / pus filled- this does not indicate bacterial infection- hence no need of antibiotics and no chance of blood contamination.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Muhammed Aslam T. K., Pediatrician </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 pregnancy after non penetrative sex? Patient:Hey The other day me and my girlfriend were rubbing each others private areas above the clothes, like little bit of fun. I then went toilet and noticied I was erected and also had pre-cum on my boxers. I only touched my penis with my right hand, and afterwards I washed my hands. After awhile of doing other things such as buying food, eating food and also hugging my girlfriend. Me and my girlfriend then started fooling around again, and I started to rub her vagina with my left hand. We've never had sex and she is still a virgin, but she is worried that she is pregnant, is this possible? [/INST] Doctor:HiDr. Purushottam welcomes you to HCM virtual clinic!Thanks for consulting at my virtual clinic. I have carefully gone through your case, and I think I have understood your concern. I will try to address your medical concerns and would suggest you the best of the available treatment options.1] Please do not panic.2] there are almost no chances of getting pregnant without penetrative sex, and without spillage of semen in and around vagina.3] Please wait till her expected date of periods and do urine test for pregnancy , if she crosses the dates.4] The chances are that she is not pregnant.5] I will suggest to get proper sex counseling done. Use of condom will protect not only from unwanted pregnancy but also from STDs.I hope my answer helps you.Thanks.Wish you great health.Dr Purushottam </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Q. I am suffering from nausea, headache, and chest pain after having cold foods. Why? Patient:Hello doctor, I am 28 years old. My weight is 55 kg. Whenever I am taking cold foods, I am suffering from nausea, headache, and chest pain. Kindly advice. [/INST] Doctor:Hello. You feel those symptoms when you take cold foods, and so you may likely be having symptoms of common cold and malaria. The chest pain could be a symptom of an ulcer. There may also be fever, I presume. You can run a test for malaria (blood film) if it is positive then treat it. Tablet Artemether Lumefantrine 80/480 mg b.d (twice a day) for three days, tablet loratadine 10 mg b.d for five days, tablet vitamin C 2 t.d.s (thrice a day) for five days. Add tablet Rabeprazole 20 mg b.d in case of ulcer. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes discomfort under the arm? Patient:For a few months I have the sensation of a fullness of sorts under my arm. Sometimes feels like it s in my arm, other times it feels like on the side of by breast (recent mammogram was normal). Sometimes it feels like a pulsing or even a bit of a pain. No lumps are found. [/INST] Doctor:HiThanks for contacting health care magic.I understand your concern. If no lump is there and mammogram is normal than you should not much worried. If still you have doubt in mind, you can consult surgeon.Pain and fullness around your arm might be due to muscle pain. For that you can try simple analgesics like Ibuprofen 400 mg 8 hourly.If you have trouble in raising hand, it might be frozen shoulder. You can consult physiotherapist for that. Thanks. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Can late and irregular ovulation cause problems while conceiving? Patient:Hi, I have been trying to conceive for just over a year now. I was on the pill from when I was 15, I came off it Jan 2013 (I am 29 years old). I have a 29 day cycle. I started using the clearblue fertility monitor. One month I ovulate mid cycle, the next month is always very irregular. The first time I ovulated around day 17/18 of my cycle and this time the fertility monitor has shown high levels of estrogen from day 12 - till today day 19 and I still haven t peaked and ovulated. Is late ovulation a problem? Is there a way of regulating when I ovulate? Could this be why I am struggling to conceive? Thanks so much in advance for your help. [/INST] Doctor:Hello Mam, I just read your query.* See normally ovulation occurs around 14th day of cycle. But it may vary, so women are adviced to conceive between 12-14 days of cycle. But the ovulation period may vary in every woman according to her hormones and cycle.* As you have mentioned about fertility monitor and you are keeping an eye on ovulation. But let me clear you one thing that along with ovulation, size of egg and rupture of egg is also important. Sometimes size is mildly lesser than the normal size and sometimes egg is normal in size and ovulation occurs but egg did not rupture as a result one will be failed in conceiving.* So I advice you to start taking Tab. Folic acid(5mg) one tablet once a day. As it will help in proper growth of egg.*If you still want to give some more try without help of doctor then take this tablet daily for three months and keep on trying. * Other way is take this tablet and go for ovulation study in a nearby scan center as it will provide you the exact knowledge about your follicle and if somehow follicle does not rupture and you will come to know about this,then you can consult your gynecologist. She will recommend you one injection which help in rupturing and it would be easier for you to get conceived * Eat healthy and fresh food. Do exercise and walk daily as exercise and walk will help in increased pelvic blood flow as a result better uterus health.* I know that you are completely concerned about your problem,but still go for general check up of your husband as well as for his semen analysis too. * All these factors will help you in solving your problem.* I hope you are satisfied with my answer. Thank you. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes swollen bump on the upper left side of my hard palate? Patient:I have swelling/a bump on the upper left side of my hard palate, above #14-15. It is painful to the touch and hurts when I swallow. Radiographs show no signs of infection. It started 2 days ago and has not changed, It is just as big and just as painful, if not more. [/INST] Doctor:Hi Dear,welcome to HCM.Understanding your concern.As per your query you have swollen bump on upper left side of palate which is painful and causing difficulty in swallowing is nothing just a irregular shaping of the hard palate bone. It is palatal torus, which is a normal overgrowth of bone on the roof of mouth. Sometimes food or toothbrush can scrap the tender tissue stretching over the torus causing pain.If it is very near to tooth and gingival recession is there then it could be due to calculus deposits in and around tooth of that area.Need not to worry. It is a self correcting pathology if it is palatal torus and will attain normal shape soon. If it is really troubling you then removal is the best treatment option in that case. Upper denture is also made to cover this torus area to prevent irritation and ulceration on it again and again.Visit dentist once and get it examined properly. If it is calculus related proper cleaning and scaling is required in that area. Antimicrobial mouth wash is required on daily basis. Once that area will be clean swelling will subside and your symptoms will resolve immediately.Hope your concern has been resolved.Get Well Soon.Best wishes,Dr. Harry Maheshwari </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Q. I started second pack of birth control without taking placebo pills to skip period. Am I safe? Patient:Hello doctor, I have been on my birth control Yaz for 10 to 11 months. Last month, I went on a holiday which collapsed with my placebo pill days with period days. So I started the second pack skipping the placebo pills from the previous pack to skip the period. However, ever since I started the second pack, I have been having spotting and later with breakthrough bleeding. So I decided to stop my second pack at the 11th pill to have my period (so together with the previous pill pack, I took 34 active pills before I stopped taking for a period). I took a four-day break as instructed from the pill pack instruction and started a new pack afterward as usual. It has been seven days from now in this new pack, and I had sex with my partner without extra contraception (condom), is it safe? [/INST] Doctor:Hello. As you were on pill regularly so that ovulation did not occur possibly. This means you are safe most probably, but 100 % accuracy is not there. But for practical purposes, it is almost safe. Take a urine pregnancy test after two to three weeks, and that will confirm it. </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 an elbow? Patient:I have severe pain in my left inner elbow with what feels like a knot/swelling over the medial epicondyl. I am an RN, and have had what they thought was golfers elbow in the right elbow, with a steroid injection, with little relief. This is in my left. I am going to an Ortho hand Dr next Monday, but I am concerned if it could be fluid or a cyst, or just inflammation. [/INST] Doctor:Hi,It may be golffer elbow, but to make exact diagnosis get xray of involved elbow done in AP and ly view and send me the report.For differentiating swelling or cyst you need to have physical examination by orthopedic surgeon as without examination nothing can be said.You may upload the picture if you can, I will help you definitely by seeing picture of elbow.Till then have tab.aceclofenac100mg +serratiopeptidase15mg thrice a day by prescription.Thanks,Dr.CHANDER MOHAN SINGH </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Need medicine for pain due to scoliosis, lumbar and mid back arthritis Patient:my so-called pain management doctor fe along with feels my scoliosis, lumbar and mid back arthritis along with deteriorating disc disease is treatable with vicodin 5/325. I am strongly disagreeing. The simple fact is (of course) pain worsening and I m barely able to funtion with my daily activities...such as simple as doing a load of laundry or dishes. I can not remember the last full night that I actually made it through the night without waking up in pain. please help me [/INST] Doctor:Dear patient vicodin is only symptomatic treatment for any kind of pain whether back pain or joint pain. If you have scoliosis and back arthritis diagnosis should be confirmed by xray of dorsolumbar spine anteroposterior and lateral views. Your night sleep is disturbed by pain which means significant disability. you need to consult immediately to spine surgeon for detailed assessment. Meanwhile start tab ultracet twice a day for pain relief. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What does BP of 147/95 suggest? Patient:I have blood pressure reading of 147 /95 is this regarding high blood pressure? I am 38 , healthy despite having cancer 3 years ago I am all clear but have had early menapause 3 years ago.I weigh 10.5 stone and 5 foot 5.Been feeling a bit dizzy for a few days. [/INST] Doctor:hello,I have gone through your query.Thanks for using HCM.your BP is marginally high.you should restrict your salt intake and exercise regularly.You should plan weight reduction of 10% of existing level.My best wishesDr.Rajesh Teli,MD. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: How to treat pressure and pain under the foot after fractured foot? Patient:Hi, I have just been in a fracture boot for 5 weeks. I had a foot fracture on the top part of the foot. Now I feel tingling and pressure pain underneath where the arch and ball of foot. Why am i feeling this if my fracture was on top. Do I need therapy or is daily swimming enough. [/INST] Doctor:hiits because of stiffness of soft tissues below foot due to plasteru need physiotherapy n u will b finethanks </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What could cause throbbing sensation on right foot? Patient:For the last two days I have had a throbbing tingling sensation on the right side of the arch of my right foot. when messaged for a long time it subsides. But returns as soon as I start to walk a lot. It comes and goes in 1 - 2 minutes intervals and the sensation is stronger at times that others. [/INST] Doctor:Hello,Throbbing pain in foot may be caused by many medical conditions such as stress fracture, a sprain in the ankle, Achilles or peroneal tendonitis, ball of foot pain. There are a number of ways to deal with these types of injuries. I suggest stretches, exercises, medication and wearing the correct type of shoes are essential in having healthy feet.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Dorina GurabardhiGeneral & Family Physician </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What may be the possible causes for infertility? Patient:Hi doc, i've been married for almost 3 years now and havent concieved yet, is it true mumps, anxiety, and stress cant make me conceive. After our sex i've noticed that he has a small amount of fluid, he experienced electricution also, that possibly the cause also of infertility? Pls help me. Thanks doc. [/INST] Doctor:hai, Mumps, prolonged stress and anxiety will leads to infertility.mumps in childhood will effect the testicles and stress, anxiety- depending on his surrounding atmosphere(working place,family etc) will lead to infertility.and the normal seminal fluid should be around 2 to 6ml. Electrocution will also lead to infertility depends upon the severity at the time.Better do semen analysis and consult your specialist for further management.'Hope I have answered your query. If you have any further questions I will be happy to help". For Follow up queries, end with "If you do not have any clarifications, you can close the discussion and rate the answer. Wish you good health </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: What causes a decrease in the heart rate after switching from Atenolol to Metoprolol? Patient:I took 500 mg Atenelol per day (300 in am and 200 pm) At the moment there is a shortage of Atenelol and my dr. switched me to Metoprolol 200 in am and 200 in pm. My heart rate has decrease in the last couple of days from normal 72 to high 90 s. Can this be related to the switch? [/INST] Doctor:Hi Greetings from HealthcareMagic As far as Atenolol and Metoprolol are concerned there is not much difference. As Metoprolol is started fresh, its blood level will rise day by day. Maximum effect will be there after 10 days . So just relax and wait for a few days more . What is level of BP? If you have any further query then you can come back to HealthcareMagic. I will definitely help you and guide you appropriately. Take Care Dr varinder joshi </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Can intake of anti depressants, affect the liver? Patient:In May 2010 I had a perfect liver. Around that time I started take the anti depressants, Lexapro, Trazodone, and Wellbutrin starting three months ago. I've also been taking Aderall since last may. Now I have an abnormal liver. Could any of these medications be the cause of my liver problem? Thank you. [/INST] Doctor:Hi, I had gone through your question and understand your concerns.Yes, Welbutrin and Trazodone are known to have some minor effect on liver enzymes so this could be cause of elevated liver markers such as SGOT and SGPT. If this is just slight elevation then medications should not be changed but if there is significant values then you should consider switching it to another antidepressants. Also, you should avoid alcohol, and fatty food till liver findings stabilize. All medications changes should be discussed with your doctor. If liver abnormality persist no matter of medication stop then you should look for some other causes such as fatty liver or viral hepatitis. In this cases ultrasound should be done and viral markers as well.Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Severe stomach pain. On healthy diet. What is it? Patient:Hi. I have been having extreme stomach pains. (I am going to the doctor's this weekend if I can get an appointment but it is so painful that I would like some advice now. I eat a VERY healthy plant-based diet. No milk, no refined carbs, etc. I either run 7 miles or go to the gym and work out on machines everyday (one rest day per week) and I do pilates and yoga. For about a week and a half though, I have been having UNBEARABLE bloating (and gas!) It has been cutting my work outs short and making my life a living hell. It is a "gurgling" pain (I don't know how else to put it) in my lower stomach and happens right after I eat and even just randomly when I haven't eaten in a while. What could it be? [/INST] Doctor:Hi, Welcome to HCM, From history it seems that you are having acute gastritis giving rise to this problem. Till you consult your doctor take some antispasmodic medicine like Meftal spas or Cyclopam tablet. Take Omiprazole or Pentaprozole tablet. Take light diet like curd, rice, buttermilk. Take plenty of water. Avoid spicy, junk food. ok and bye. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Q. How will a 7 mm uterine fibroid impact my life? Patient:Hello doctor, I am a 28 year old female, and today I went for an ultrasound scan of the abdomen, as advised by my family physician. My test report shows small hypoechoic lesion of 7 mm in the fundus myometrium. It is indicative of a fibroid, and my endometrial thickness is 7 mm. What is the meaning of this 7 mm lesion? How will it impact my health? [/INST] Doctor:Hi. How are you doing? If I may suggest, just forget the report, let me explain why. Fibroids or myomas are harmless masses in the uterus, which are hormone dependent. It keeps growing as long as you have estrogen, so once your hormones stop after menopause, it will cease to grow and may regress. They never turn malignant. If you scan 100 ladies randomly, 50 to 70 % ladies will have fibroids of varying size. But they should never be treated unless they are causing some symptoms like excessive or intermittent bleeding during periods, excessive vaginal discharge, severe pain in the lower abdomen during periods, pressure symptoms on the bladder or bowel or back or kidney, or if the fibroid is interfering with the baby. We advise any fibroid of more than 5 cm should be removed, it grows at 1 to 2 mm per year, so you should have no problem. So just forget it, maybe have a scan again after 2 to 3 years or when trying for pregnancy. 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 red, painful bumps all over the body Patient:I have slightly bigger than pimple size, red, very painful bumps on multiple areas of body (both sides). The skin within an inch around them is also very sore. It feels like a stinging pain, but it also hurts like a deep muscle ache. I haven t changed anything in my daily routine as far as soaps, detergents, etc. I was recently at the beach in North Carolina and spent most of my time in the ocean. I also used a pool and a hot tub for a minimal amount of time. Some of these bumps almost look shiny like a blister and have a head to them. They have nearly doubled in size since discovering them this morning. I have 5 on my shoulder all within 1/2-1 inch apart, 5 scattered on my abdomen, 2 on both sides about 2 inches under my armpit and on my rib cage, one on my bicep and another on my forearm on my inside elbow, and two close together on my hip. What can they be? [/INST] Doctor:Hi, dear. I have gone through your question. I can understand your concern. You may have some acne on your body. You should take doxycyclin tablet. You can go for local application of benzoyle peroxide & clindamycin. Drink plenty of water. Take citrus fruits. Consult your doctor and take treatment accordingly. 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: Kidney disease in one, other has failed. Is there any treatment? Patient:hi my name is orlando,and i desperately needs a help for my sister.my sister had a kidney disease,one of her kidney already failed.almost 70percent of her kidney doest work and only 20percent is working. - her creatinine is 1.7 and potassium 3.0.i desperately need a help.is there any means to cure here disease,what food she needs to eat and what foods she need to avoid.thank u very much [/INST] Doctor:Hi Welcome to HCM. CKD can be managed but not cured unfortunately. The essence of treatment are 1. Restricted fluid intake. 2. Low salt diet. 3. Moderate protein diet. 4. Supplementation of vitamins, iron and calcium. Please contact your nephrologist as he is the ideal person to guide you. best regards DR GS </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Q. I have constant ear discharge after an eardrum surgery. Please advise. Patient:Hello doctor, I have an eardrum perforation since childhood. I had tympanoplasty done last year but, that failed. Now, the ear keeps discharging all the time. I completed a course of Ciprofloxacin and Dexatops ear drops but after a week, the discharge is back. Please advise. [/INST] Doctor:Hello. A recurrent ear discharge after a failed tympanoplasty needs to be evaluated completely. For more information consult an ENT otolaryngologist 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 stage iv melanoma Patient:my niece has stage IV malamona and the doctors has basically refused to do anymore surgery and are planning to do what i think is the lastest expermential drug. First, they must do a BRAF test to determine if they will do it at all. Where are these test done as we are trying to make her as comfortable and not stay in hotels as we have much family all around the country. [/INST] Doctor:Hi Welcome to HCMI have gone thru your query regarding your concern over your niece's sufferings .It is a matter of great concern .I ,as a Homeopath , Naturopath and Magneto Therapist would like to help you in this . These are no nonsense, having no side effects and potent tools for recovery and prevention of diseases .SIDE BY SIDE OFHER PRESENTTREATMENT ,Administer her some supplements rich in antioxidents which add to enhance power of metabolism and strengthen immune system to help her early recovery & prevention from further reccurance....1. Give high fiber diets including all essential nutrients ,directly , as it reduce the risk of colon or any cancer, a fiber-rich diet can decrease and eliminate constipation and hemorrhoids, it helps the stool pass through easily and decreases the burden of toxins reabsorbed into the body.Avoid fried fast food ,tea coffee , alcohol and smoking .2. give Mixture of extract of lemon , garlic , ginger , mooringa tree bark( sehjan tree) , vinegar of coconut water and honey . 25 -35 ml is the dose with equal water for 3 -4 days twice 1/2 hour before meals, and after that , pure mixture for 25 - 35 days as required , is great antioxidant and rejuvinating preventive and curative drink .3. Bitter gourd has astounding health benefits. A study published in the scientific journal Carcinogenesis has shown that bitter gourd juice restricts the ability of pancreatic cancer cells to metabolize glucose, and in the process cuts off the cancer’s energy source, effectively killing them. dose is 20-25 ml empty stomach .4. Turmeric powder 1 t spoon with a cup of hot milk before B/F and at bed time . kills all kind of bacterias on mass bases 5. Buttermilk in lunch gives strength and helps digestion ,with a pinch of black salt and long pepper .6. Do Exercise ,Walk , Yoga , Pranayam - Deep Breathing , according to the capacity of the patient .7. Clearing of bowel should be Regular.8. Mental tention ,worry anger should be avoided as jt hempers healing process 9. proper Rest ,sond sleep helps in early recovery10. If you wish and have facility of service of Magneto Therapist ,this is also a encouraging way of treatment . It complements and accelerate the recovery of the patient by destroying the bacteria on mass basis , goes with any therapy and has no side effects .If this regimen regularly followed & made part of life , It assures happy , healthy and disease free life ahead .Hope this helps you solve your query .If have any doubt on any point , Mail at drsuchda@gmail.com Take Care .All the best .Wish him early recovery .Don't hesitate to get back if have any further query </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Q. How to confirm the reason for my abortion? Patient:Hi doctor, I had some hormonal imbalance problem. I had my last periods two months back. I became pregnant and took an hCG test. It was 121 and I took viability scan at 7.6 weeks. The heart rate was 92 bpm, which is less compared to one week. So, doctor suggested me to repeat a scan after two weeks. I took a scan yesterday and the report says my fetus heart rate has been stopped and there is no cardiac activity. My CRL size also reduced. I took complete bed rest as per doctor advice. I am taking progesterone, Duphaston, Folinal tablets and an injection twice a week. My LH and AMH values were a little bit high. What could be the reason for this abortion? [/INST] Doctor:Hello. 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 presence of RBCs and WBCs in semen indicate ? Patient:Presence of 22 wbc and 8 rbc in semen [/INST] Doctor:HI Welcome to HealthcareMagic You have genital tract infection for which you need to take course of antibiotics. Use barrier method (condom) till the time infection is completely cured. Treatment of infection will further improve sperm count and motility. consult your doctor for management. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Q. What can be done for swollen labia with pain? Patient:Hello doctor, I am a 25-year-old female with no children. My husband and I have been together for six years. We have no extra-marital affairs and I am 100 % sure of that. My right labia is swollen and is very painful to touch, even a slight breeze of air causes extreme pain. The pain is similar to a sunburn. It is painful enough to make me cry. The swelling starts from my right vulva next to my vaginal canal and goes all the way to my anus. The area with the worst pain is next to my perineum. This started as a painless lump in the size of a peanut that could be palpated from within my vagina with a finger but not visible externally. This was about a week ago. Now, it is huge and painful. My labia is three times larger than its normal size and very red. There are no discharges, no foul smells, and it is not itchy. I am managing the pain with Clobetasol topical cream and Mefenamic Acid orally. The pain disappears instantly with the cream but I think it is also making the swelling bigger (steroid?). I am on my third day of Co-Amoxiclav 625 mg (twice a day every 12 hours) but I think this is what caused the swelling in the first place. Also, I tried to do a sitz bath and it only made the condition worse. Just a few hours ago, I had trouble breathing (allergy?). I have never been allergic to any medication before. Any impression or advice would be appreciated. [/INST] Doctor:Hi. From the symptoms you described, it sounded like you developed Bartholin gland abscess which is an occlusion of the Bartholin gland duct and that turned to be abscess. Steroid cream is not used for treatment. You need to finish the antibiotic and continue a warm sitz bath three times a day. The abscess will get soft and drain spontaneously. If you had this previously and have the abscess at the same location, it would be better to have a procedure called marsupialization. You can continue Motrin for pain. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Will TB get fully cured after taking treatment? Patient:hi I had TB when I was 24 years old I took medician nine months and got ok, however as now I am 37 years old and not married , I found some blood in my sputum with some symptoms like mild fever continouls dry cough till 2 months and then it turn into irritation of throat and airy wihile and some time yellow sputum. recently I found some small clot of blood in my sputum and I went to sputum test and its become +fb with the result of pus cells +, Epithelial cells occasional. my chest also shows sheds and patches I am scared that if I will get treated will I be get healed and what diet and practices I take to avoid it as I work in area where I am exposed to TB Patients and Patients with number of related disease.do you think I will be cure 100% after this treatment and I can go back in same work enviornment I mention above or I need to change my work conditions. [/INST] Doctor:Hello,Tuberculosis (TB) is caused by bacteria (Mycobacterium tuberculosis). It spread by droplet infection in coughing, sneezing et cetera.So, even if you had TB in past which was cured, new infection can cause relapse of TB. So, it is quite possible that you might be having TB again.Better to consult pulmonologist and get done chest x ray and sputum report. Also rule out MDR (MultiDrug Resistance) TB.You will need 9-12 moths of anti-tubercular drugs. Don't worry; you will be alright after finishing the course. Eat high protein diet like pulses, vegetables, eggs and Wear mask at your work place.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Kaushal Bhavsar </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What does severe pain in the lower back indicate? Patient:I have a deep pain in my back. It s the right side below ribs. Hurts worse when I move. My eyes are bloodshot red also and got a headache. Been increasing over a few days. No known fever. Drinking water, cranberry juice and honey lemon water. No caffeine [/INST] Doctor:There may be muscle spasm , you need muscle relaxants like tab. Myoril , and also utrasound abdomen pelvis , to rule out any renal stone </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What could chest pain with bruises on the knee in paitnets with a family history of CAD indicate? Patient:Hi my sister had the following symptoms and I sent her to the ER sob 3nights ago mild dull chest pain 3nights ago the it went away then the next day dull left arm pain then it went away then today left leg pain behind the knee with bruising in the front of the knee she is 43 fair shape family history of CAD maternal grandfather is that a sign of a blockage [/INST] Doctor:Hi. I can understand your concern. Ideally ecg and 2d echo should be done first in her case. If both are normal than no need to worry for heart diseases.The leg pain can be different entity. She will a detailed examination by doctor for the saem.Don't worry, she 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: What is the treatment for calculus inferior pole in the kidney? Patient:Hello Sir, My Father age 50years is suffering from fever and cough and then we consulted for a doctor, He told for Ultrasound. After ultrasound it was found a Calculus (9mm) inferior Pole in left kidney.Kindly let me know is there is any major problem and what is the solution to get rid of it? [/INST] Doctor:HIThank for asking HCMI really appreciate your concern for your father from the history given here I could say that the size of stone is quit big (9mm) and so this need to be removed if this is silent at this time but later this could create big clinical problem so it is advisable to remove this, hope this information helps you, take care and have nice day. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes stomach pain in a child? Patient:My daughter has been sick since last Wednesday she has been to the hospital twice but all they ve done was was give pain medicine and fluids. She is having really bad stomach pains on her right side. She s had blood in the stool, vomiting, can t eat, and very week. They did a CT scan and says one kidney is quite larger than the other. Do you have any idea what it is? [/INST] Doctor:Hi sir,You did not specify the age of your daughter because in smallchildren below 5 yrs, urinary tract infections/kidney stones may present with the above complaints. If one kidney is larger and one is very small may be due to block of blood vessel supplying a kidney resulting in high BP may be a possibility. Please get her evaluated properly in conjunction with a pediatric nephrologist </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes severe foot pain without injury? Patient:Hurt my foot playing baseball. Had an xray, it didn t show any break but it hurts to walk on. It hurts more in the morning and when I rest it it hurts when I go to walk. If I take advice and keep moving on it it seems to hurt less. It seems to hurt more when I rest it. [/INST] Doctor:Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. If it's paining too much at rest may be a hairline fracture would have happened on the foot so kindly use the limb for betterment. I would recommend light exercises for the foot for 30 min each day to be in healthy state. Take ibuprofen preparation to reduce inflammation. If pain is too much then Diclofenac or Tramadol can be taken only with prescription for pain relief. Pain killers can give relief and healing occurs easily inside. Hope I have answered your query. Let me know if I can assist you further. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes skin rash when having cold, fever and cough? Patient:Hi Doctor, I am suffering from severe cold and fever and cough. I was trying home remedies. Right before this I had a root canal and doctor prescribed amoxcilin. Today, I notice red rashes on my skin which have increased throughout the day. are they due to heat? can febrex plus help? [/INST] Doctor:Hi, Your symptoms seem to be related to a viral infection.I suggest you to use anti inflammatory medications such as Ibuprofen three times a day.I also suggest you to use calamine lotion for local relief. Hope I have answered your query. Let me know if I can assist you further. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Is it to be concern about child yawning often? Patient:my 5 year old boy started yawning several times during the day about 6 months ago. we initially thought it was just a tic and that it will go away, however, he still does. we also thought he needed to go to bed earlier, but that has not stopped his constant yawning either. i do not think this is normal and i wonder if i should take him to a pediatrician. any advice? thank you very much [/INST] Doctor:Hi, this is a habitual thing, you need to counsel the child that he should not yawn repeatedly. As child grows this yawning will decrease, don't be too angry on child and counsel him with tenderness. Take care. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Have chronic pancreatitis. Lower abdominal pain. Ultrasound shows abdominal ascites. Cure? Patient:Dear Doctor,My father is an patient of chronic pancreatitis but don't having sugar at present,he having an continous pain in the lower abdomen,and in ultrasound their is an ascites in the abdomen,doctor took out the sample of the fluid in the abdomen sent it to lab to test,then they found it an abdomenal TB case,they give the medicine for TB, after 15 days as well my father is having pain sometimes in the back & sometimes in the Abdomen ,and after taking the meal in the morning he having very bad pain,and it subsides slowely after 2 hours, my father already taking the digestive enzymes tablets with the meals. can you please help me what we should do to cure all this.waiting for your reply. regards pankaj( YYYY@YYYY ) [/INST] Doctor:Hello, Thanks for the query to H.C.M. Forum. Ascites fluid is due to tuberculosis abdomen. Treatment of tuberculosis is continue, so a good thing. Still pain present as note down , why?Abdominal pain is the major symptom of acute pancreatitis . Pain may vary from a mild to severe , constant & incapacitating distress. Pain in the abdomen is due to pancreatitis . 2nd reason of pain is due to anti tubercular drugs as these develops hyper acidity and gastritis. Consult your treating physician & another physician and get 2nd opinion also. Good luck. Dr. HET </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes pain during bowel movement in a child? Patient:Hi my 5 years old child has big problems when ever he wants to go to toilet. He told me that he has pains when the stool comes out. Most of the time he prefers to start his kaka on his pants and he goes to toilet. Yesterday I saw that he has very inflamated anus, what would be the cause and solution for this problem. Thanks [/INST] Doctor:Hello and welcome to healthcare magic.Painful defecation and sore anus may be due to following reasonsAnal fissures:Prolonged constipation and straining can cut the anal skin leading to anal fissures which is a very painful condition and can exacerbate the situation by creating fear of defecation and retention which lead to leaking stools and soiled pants.To rule out this condition he needs to be examined by paediatric surgeon.I advise xylocaine gel,sitz baths and stool softener in such situations. Pinworms:They irritate th sensitive skin moreover itching can also lead to raw skin.Contact of stools with raw skin will hurt alot specially if the stools are hard.Local examination,Stools inspection and stool routine examination will cofirm the diagnosis.I prescribe zinc oxide cream and Albendazole syrup in such situations.Food allergy:It makes the stool acidic which irritates the skin and similar condition develop as in pinworms only that acidic stools will burn the skin more.Stool test for reducing sugars can confirm the diagnosis.Zinc oxide cream and omitting the alleged food will be my advice in such situation.4th Condition which is very sensitive and grave matter both for you and us(ur treating team) that is sexual abuse must be kept in mind.It can lead to sore/inflamed anus and fear of Defecation.AND you MUST be very vigilant to keep an eye and must INTERVENE if such situation is possible.Hope you find this answer helpful.Good luck! </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Are mild fever, body aches, cough and severe congestion symptoms of Lyme's disease? Patient:Yes, I have had a low-grade fever, body aches, cough, severe congestion and enlarged glands for approximately 4 days. I was thinking that it was just a virus exacerbated by allergies, however, I can t help but be concerned about lyme disease. How should I proceed with dealing with this. I m miserable. [/INST] Doctor:HiThanks for your query at HCM.I understand your concern and situationThe patients of Lyme disease have rash, called erythema migrans, is one of the hallmarks of Lyme disease. Some people develop this rash at more than one place on their bodies. Flu-like symptoms. Fever, chills, fatigue, body aches and a headache may accompany the rash.I suggest you to take rest and get tested by a physician.Take careDr Sheetal Verma </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: neurology problem Patient:dear mam,i am suffering from neurology problem from past two years.i usually get strained when i walk long,when i turn around suddenly,when i get stressed mainly during exams,.....i will have a feeling of giddyness or whether my brain is becoming weight on what side i bend...this is my problem..i have already many neurologists..but no use..so i am expecting from you for the right solution......please [/INST] Doctor:How come you know that this is neurology problem? Has it been diagnosed? </s>

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

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Q. Can extraction of a wisdom tooth cause irritation in the nerve of the head? Patient:Hello doctor, I have pain like irritation of the nerve on the left side of the head exactly on the left temple, in the left jaw, in front of the ear, back and around the ear, below the left jaw, which radiates to the left side of the neck. The pain is constant and irritating. Doing jaw movements helps a little in reducing the pain and relaxing the jaw muscle. But then after few seconds, there is a recurrence of pain and irritation. I had doubt that it could be a TMJ problem, but there is no sensation of cracking in the jaw, but a slight feeling is there when the jaw movement or jaw stretching is done. This pain does not limit the opening of the mouth. Opening the mouth is not a problem. More than the pain, the irritation of the nerve in the above areas is bad. My wisdom tooth was extracted five days back, as it was impacted. Could this be the reason? This problem did not subside even after removing the tooth. Please help. [/INST] Doctor:Hi. For further queries 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: Q. Is it true that Ashwagandha has bad interaction with anesthesia? Patient:Hi doctor, I am due to have a surgery cone biopsy for CIN 3. I am stopping all my supplements a week before, as requested by the hospital. However, I ordered an herbal medicine last week, Ashwagandha, to try for insomnia and nerves. It was dumb to try without consulting a doctor. I think I have only taken it three to four times in total, about half teaspoons of the stuff for each dose over the last week. I had almost a half teaspoon with water. I just looked online that they advised to stop taking Ashwagandha at least two weeks before surgery as it may have a bad interaction with anesthesia and also may cause bleeding. I have never had general anesthesia before and I am somewhat terrified of not waking up from it already. Another doctor advised to stop taking the stuff one week prior, which puts me in the clear. I wanted to have your opinion on it. The last dose was 48 hours ago. Do you know about this herb and its dangers with surgery? Do I need to reschedule my surgery? [/INST] Doctor:Hi. Regarding your query, it seems you have already searched a lot on the social networks. For further doubts consult an anesthesiologist online --> </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Q. Please suggest a treatment for the swelling in my lower eyelid. Patient:Hi doctor, I got a swelling in the left lower eyelid as can be seen in the picture before four days. It is painful and the eye turned red. Since yesterday, I have been using Ciprofloxacin eye drops, but there is no relief. I got similar problem in my right lower eyelid a year back. Since, two months I am staying in hot climate. Also, I have mild dandruff. What is the diagnosis and treatment? [/INST] Doctor:Hi. I have gone through the pictures of your eyes (attachment removed to protect patient identity). Revert back after a week to an eye care ophthalmologist online --> </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Diagnosed with liver cirrhosis. Suffer from joint pain with stiffness. Any solution? Patient:i was diagnosed with cirrohsis of the liver 6 months ago. I began suffering from bad joint pain and general body aches. I get very stiff and sore after sitting or remaining in the same period for fairly short periods of time. I do not consume any alcohol and follow a diet of low fat , low sodium and limited protein. Is this a normal result of this disease? Are there any adjustments I can make to help remedy this? [/INST] Doctor:Hi, thanks for writing in. Cirrhosis associated with arthritis could be due to some autoimmune disorder. You need to under investigations for autoimmune causes of arthritis. You should consult a rheumatologist for the exact investigations to be done. Regards </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Are the bubbles in the urine dangerous after gall bladder removal? Patient:What does it mean when you have bubbles in your urine? My husband had his gallbladder removed last month due to gallstones and an inflamed gallbladder, and now starting just last night, he s been noticing a lot of bubbles in his urine. Does he need to be check out by a doc? Thanks for your time. [/INST] Doctor:Hi,there is no need to worry as such there is no co relation with gall bladder removal and bubble in urine .AND i dont think that is a major issue it will settle down automatically just drink plenty of water.Hope this information helps you thank you </s>

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

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes unusual eye movements in an infant? Patient:my 2month old baby is having unusual eye movements when awake, both eyes are moving fast from left to right. although it does not happen too often, my pedia said that it might me nystagmus, however my ophthalmologist said that it s not.. im really worried. please help [/INST] Doctor:movements like this may b normal in children at this age group.yes this also may b nystagmus. which may b due to problem in cerebellum or inner ear. dont be too worried but workup is needed if it persists. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Q. What is the possibility of previous staph infection causing septic shock? Patient:Hello doctor, I had a staph infection and I took antibiotics a month ago. I had been in the sun a lot recently and I am feeling symptoms of heat exhaustion, but I am worried that the staph infection is causing septic shock? Is this a possibility? [/INST] Doctor:Hi. I can understand your concern. According to your statement, you have been suffering from a feeling of heat exhaustion as you were more exposed to the sunlight and worried about Staph infection that may cause septic shock. You had a staph infection one month back and you took antibiotics for that. So I think your previous staph infection was well eradicated by taking antibiotics. Even without treatment, it can be eradicated within 10-20 days. Staph infection may cause life-threatening condition like sepsis. Clinical features of sepsis are high fever with chills and rigors, rapid pulse rate, rapid breathing, hypotension, vomiting, diarrhea, etc. When staph bacteria enters a person's bloodstream and develop an infection that may affect the entire body and cause death is known as sepsis. You are not mentioned here that you are affected by sepsis-like clinical features and no history of having sepsis in the past. So now you are free from staph infection and no chance of sepsis caused by staph infection. I hope this helps. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What could swollen neck glands with lumps on armpit suggest? Patient:Hi,A few weeks ago I had very bad swollen glands in my neck which I was put on antibiotics for but, now a lump as appeared under my armpit. It started off very itchy and is under the skin, it is quite hard too and has become very sore, I think from the scratching. I am worried because I have read a lump under the armpit and swollen glands could be a sign of cancer? Could you advise me please? [/INST] Doctor:it is definitely an infective pathology and could be acute inflammation of the lymph nodes, tuberculosis, fungus, bacteria, sebaceous cyst or even infection of skin sweat glands....just have an FNAC test for confirmationall the best! </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 rashes which occurred after diarrhea? Patient:I have been having red spots on my arms, average size of an inch in diameter. They start with an itch. And typically are gone within a day, only to be replaced with similar spots ans symptoms in other places, again mostly on my arms, but a few on my torso as well. Not sure whether related, I had a bout of diarrhea last Wednesday, and ever since, have noticed reduced appetite. The diarrhea is gone now, but there is a bit more bloating than usual and still reduced appetite. Rings a bell? Thank you. [/INST] Doctor:Hi, I have gone through your complaints and it seems to be an urticarial rash. It can occur secondary to any infection in the body like diarrhoea in your case. I would recommend you to take antihistaminic like tablet Cetirizine once daily for a few days. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Asmeet Kaur Sawhney, Dermatologist </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: How to reduce throbbing pain in front thigh? Patient:I have been having tremendous throbbing and it is excruitiating pain starting with my front thigh and then traveling down my leg (left side) and now 24 hours later the pain is in lower leg below my knee I used a heating pad and ibuprofen and still hurts bad. [/INST] Doctor:HiFor now, it's good to do hot fomentation and take ibuprofen, but do get examined for cause finding by an orthopedist.Throbbing calls for exploring to rule out neuro-vascular (risks) offending cause..if it'turns out not to account for it, then simple rest, calcium vitamin D3 supplements, neurobion forte,and evion may be added along with current treatmentBest wishes </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Q. Can disc herniation cause testicular pain and make my testicles to retract? Patient:Hello doctor, I am a 48 year old male. Ten days back, I noticed that my testicles has moved up and are receding into my groin. I also have a dull pain in the testicles. This pain is not always there, but it happens on and off. I am worried that this may be a serious condition. Could you please let me know what could be the reason for this condition. Which specialist should I consult in my city? I would also like to point out that I am also suffering from lower back pain for the last couple of months. The pain is in the lower back, right hip, and also both sides of the lower abdomen. I got an MRI last week, which showed herniated disc in L4-L5 region of the spine. The doctor suggested endoscopic spinal surgery. I am yet to take a call on this. I am not sure if the above two conditions are related. Are both my issues related? [/INST] Doctor:Hi. Sorry to hear about your pain. For more 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 painful lump on top of spine with neck stiffness indicate? Patient:I have just noticed a hard like painful, marble sized lump at the base of my neck on left side at the top of my spine. My neck is very stiff and feels like a muscle pulling down into my shoulder. The lump moves when I touch it, and feels like a marble. What could this be? Any idea? [/INST] Doctor:Hi, dearI have gone through your question. I can understand your concern.You may have occipital lymphnode enlargement. or you may have some soft tissue tumour like lipoma or neurofibroma. You should go for fine needle aspiration cytology or biopsy. It will give you exact diagnosis then you should take treatment accordingly.Hope I have answered your question, if you have any doubts then contact me at bit.ly/Drsanghvihardik, I will be happy to answer you.Thanks for using health care magic.Wish you a very good health. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Unable to sleep due to anxiety and depression. Feel very tired. Cure? Patient:Hello doctor ..My name kamal I m 21 years / male .......l sufrred from a depression I m afraid when I m go to bed and couldn t sleep then everyday I thinking how I can sleep today then this illness is effect on my education then my health then cause no thing make me happy still nw I forget this feeling . When I have any work nextday I couldn t sleep and I m thinking what happen nextday then if I couldn t sleep How I do anything nextday then I m feeling disturbance I m very afrid to travel with my ?friend becuse this feeling .actully I m very tired I m feling I m extoic guy what can I do [/INST] Doctor:Hello and welcome to Healthcare Magic. Thanks for your query. From the description of your problems, it appears that you may be having both anxiety and depressive symptoms. Since, these problems seem to be causing you a lot of distress and sysfunction, you need to seek professional help to come out of this phase. There are effective treatment options for this, in the form of medication or counselling / psychotherapy which will help you overcome your problems. So, I would advise you consult a psychiatrist for a detailed psychological assessment and further treatment. Wish you all the best. Regards, Dr. Jonas Sundarakumar Consultant Psychiatrist </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest treatment for infertility Patient:Doc ia m 26 and my husband 31, we are married for 4 years but no child still nowAfter testing we found that my husbands count is nil. But he insisting a baby from his father he is 65. is it advisable to receive semen from a 65 year old man?Can we get a healthy baby? [/INST] Doctor:Hi welcome to healthcaremagic.I have gone through your question.If sperms of 65 years old man has good motility ( 30% atleast active motile) and normal count (20million/ml) then there is no need to worry regarding that.Hope i answered your question.Would be happy to help you further.Take care. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What are the red rashes on my groin area? Patient:I most of the time get red rashes on groin area and after applying some ointment disaapear but few days I get the same and irritation is horrible. I on Dr. advice had applied Propy zole and it help for qyite few months but now I am getting same troube. Please advice. [/INST] Doctor:Rash in groin area occurs most commonly due to fungal infection. This happens due to wearing of tight inner wear, continuous sweating in that area and rubbing of the cloths .Apply terbest ointment twice daily.Try to avoid tight innrwears, skin feat pants.Keep groin area clean. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes cramps under ribs after gall bladder removal? Patient:Hi my name is Tami! I had my gall bladder removed Aug. of last year and the reason cause I was having cramps underneath my ribs and back and my lining of my gall bladder was very hard and my liver enmzes were high! Well this morning at 1am I woke up to the same cramping under my rib cage and cramps in my back and same problem as before my removal if my gall bladder! My question is how is this suppose if my gall bladder is gone? Can I still develop gall stones? [/INST] Doctor:hi.what you're probably experiencing is post-operative pain or discomfort. this usually occurs on the first few days after your surgery and will eventually subside. the pain/discomfort after gallbladder surgery occurs not only the post-operative site area, but also over your flanks and sometimes back region. complete your antibiotics as prescribed and take your pain medications as needed. a follow-up with your surgeon is also best for clinical evaluation.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: Should I consult a specialist for chronic kidney disease while taking Metformin and Losartan? Patient:I am a type two diabetic. I just found out that I have stage 3 chronic kidney disease. What medicine should I take to help so this disease doen't get worse? I walk atleast two miles a day and work for another 20 min. I take Glimepride 2mg two pills twice a day and Metformin 1000mg wice a day alonf with Losartan 100mg once a day. I also take synthroid .075mg oncw a day. Shouild I see a specialist?Thank You [/INST] Doctor:hello sir thanks for the queryCKD chronic kidney disease complication of diabetes..the bitter act of diabetes is dat a doctor can only delay the onset of complications and delay its progression but can never prevent frm complications occuring..in ur case metformin is nt ptrescribed if creatinine is more than 2.5 and u r losartan will take care of progression of complications...but once u r diagnosed as CKD a detail work up is required as to asses when u require dialysis and any plans for transplant...anf to evaluate other diabetic complicationsThank you </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Back pain. On morgan 10, forceful as needed for fibro. Suggest something stronger for back problem Patient:I take morgan 10 3 Times daily and forceful as needed for fibro. My back has been bothering me for two weeks and it has gotten worse. I won't go to emergency room because I signed a pain contact and I don't want to get in trouble. Can I go to my regular Dr and she is she can prescribe something stronger just enough to get over this back problem? [/INST] Doctor:Hello,Thanks for writing to us,As per your symptoms probability is lumbar disc bulge compressing your spinal nerves leading to pain in your hips and down.MRI spine will confirm diagnosis so I will advise to do that.Muscle relaxant with neurotropic medication will help to relieve symptoms.Till that time Physiotherapy like USG and SWD will give some reliefProper spine stabilising exercises are very important for maintaining pain free state.I hope that I have answered your query. Let me know if I can help you further. Take care. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest treatment for abdominal pain Patient:I was fine this morning and had breakfast however right after lunch I felt a tiny sharp pain in my lower right side abdomen almost right below the belly button. I wear a belt to work which made it worse and I felt bloating. I also got my period yesterday. Anyhow I started feeling more tight around my lower abdomen towards 2 pm. I took off my belt at work and walked home. On the walk home I felt my back as if it was being pulled apart and my legs started to feel weaker. I got home and felt a little chilly and jumped in bed I tried to close mg eyes and sleep. I slept very little but I rested. Now I notice as I lay on my back that when I breath in fully a feel a pain in my right lower and abdomen and when I put pressure on it with my hand I feel pain again. Not severe but enought to worry me as its something that s never happened before? What are your thoughts on this? [/INST] Doctor:Hi,From history it seems that there might be having some food poisoning effect after lunch giving rise abdominal colic, fever, chills etc.Take antispasmodic medicine like Meftal spas and ofloxacilin, tinidazole combination medicine for 3 days.Take plenty of water.Take light diet for two 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: What is the cure for Perinatal abscess without surgery? Patient:How can I cure my periantal abscess I have an abscess and I had a surgery and took my larg intestine after that I developed an infection periantal abscess and my doctor sayed if I thave ostomy my infection will go away but I don't want the ostomy I want to cure it without it [/INST] Doctor:Hi.This is very true.As this looks to be a '''high '' fistula traversing through he sphincter ( which controls the passage of gases and stool) can not be excised or the else it will cause incontinence ( loss of control).The first thing to do is to go for : a ''FISTULOGRAM'' TO decide the level of fistula.IF you do not want to have a colostomy= ostmy, you may try '' KSHARSUTRA'' DONE BY A QUALIFIED AURVEDACHARYA., where he will pass a medicated thread. It needs changing from time-to-time.If does have a great role, although it may take 1 to 3 months , it helps in many patients with a condition like yours. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Is it normal for pain to kick in days after a bike injury? Patient:My bike slipped out from under me when I hit an icy patch a week ago. A massive bruise formed over my greater trochanter and the coloration spread all around my thigh, but there wasn t too much pain. 6 days after the fall, I started getting intermittent sharp stinging pain from my thigh. The pain is so intense that I can t stand on or move that leg much, and this lasts for minutes to a couple hours at a time. Is it normal for pain to kick in days after an injury, or is this some sign of a complication? Also, is it typical to have symptoms of whiplash develop a week after a hard fall? [/INST] Doctor:Hi, thanks for using HCM.Pain after a week of injury could be due to nerve compression due to swelling in thigh or damage to femur neck. Examination required to confirm condition. Consult your doctor for examination and further management.Regards </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest treatment for headache and skin sensitivity Patient:Hi Im a 33 year old male ...I am healthy and fit and eat a low carb diet....I have bouts of tiredness and a dull pain at the side of my head.My upper thighs some times feel sensitive and my ankles and arms.The skin does feel sensitive.Also my anus has been itchy. This is ruining me.I am very down about this. [/INST] Doctor:Hello!My name is Dr. Aida and I am glad to attend you on Healthcaremagic!Your symptoms could be related to a metabolic disorder. The itchy anus could be related to a fungal infection or hemorrhoids. Coming to this point, I would recommend consulting with your GP for a physical exam and some tests: - a complete blood count for anemia- thyroid hormone levels for possible thyroid gland dysfunction- cortisol plasma levels for possible adrenal gland dysfunction- blood electrolytes- fasting glucose- kidney and liver function tests- a chest X ray study- a urine analysis-a stool bacterial culture. You should discuss with your doctor on these tests. Hope you will find this answer helpful! Best wishes, Dr. Aida </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes a red ring around the anus in children? Patient:My 7 year old has a red ring around his anus. He complains that it hurts and stings. He has had this same problem before. I have in the past put baby Desitin on it to help. I think it may be from sweat and maybe a wet swimsuit, but I m not sure. Is this the best way to treat it? [/INST] Doctor:Hi, I had gone through your question and understand your concerns.. You should be worried but not too much. It seems your baby has Candidiasis, that's why Clotrimazole or Candid powder also can be useful. Try to do air bath also.Avoid wet and synthetic clothes.Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you and your child good health. </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: B+ blood group, wife is first cousin, child s brain not fully working compared to others of his age. Can I have another baby ? Patient:i have a B+ blood group and my wife who is my first cousin as well has B- ,we have married five and a half years ago we got a baby boy during her pregnancy we found out through the doctors that she needed a Rhogam injection otherwise the baby or the mother might die. so she had that injection now our boy is four and a half years but he has some problems like he can not speak and his everything was delayed compare to other children. now i don't want to have another child because my child brain is not fully working compare to his age other children. so now you tell either we have to separate or we can have another baby which i don't want to have.thanks for your answer. [/INST] Doctor:Hi,Well u have a history of consangiounous marriage means" marriage amongst first degree relatives.That might be cause of problems in first baby.Well u can plan but will need to do a triple marker test in 12-14 weeks to find out other genetic abnormalities.A detailed 4 scan and targeted scan of second baby might be helpful. Consult ur gynaec for evaluation of ur patient for pre pregnancy evaluation.High doses of frolic acid will also be require prepregnancy and in first trimester.Byee </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Are cold flashes possible in males? Patient:Usually once a month for the last ten years, i will wake up in the morning and start shaking very badly. I shake bad enough that I can hardly walk, and cannot keep sugar for my coffee on a spoon. I am 57 years old, 5'11", 195 lbs. Are there such a thing as cold flashes like hot flashes in males? [/INST] Doctor:Hello and thanks for your question.It's my first priority to help you.Flashes can be associated with andropause due to low testosterone levels.And you should check your serum testosterone levels.Even your blood pressure and blood sugar levels should be checked.Hope this helps. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Is difficulty in breathing due to bronchitis or gas? Patient:im a 22 year old smoker, have been smoking for seven years,recently i was diagnosed with acute bronchitis, i was having breathing difficulties, but i get the feeling its a gas related problem , i had a spirometry done, which says my FEF 25-75 was 36 % of the predicted value , Fev 1 73 % and FEV 3 97 %, can this happen due to acidity, also my doctor says it was an allergy problem and it wont happen again, can i smoke again after recovery ? after 2 weeks of formonide 200 my test results were FEF 25-75 was 73% , FEV 1 96% and FEV 3 111 %, i want to know is this gas related, could it be or is it bronchitis ? [/INST] Doctor:Hey first of all please don't start smoking again.This bronchitis episode, consider it as red signal.And all this changes of values in PFT after Formonide shows that it was lung related. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Q. Can sound from a loudspeaker cause any effect on my eardrum? Patient:Hi doctor, I went to a chant few days back. There the loudspeaker was very loud. The very next day I noticed that there is ringing in my left ear. Now, it has been four days, but it has not gone. Can you help me? I am very scared. Has it caused any effect on my eardrum? Please see to it. Thank you. [/INST] Doctor:Hello. From your history of noise exposure and symptoms, it is suggestive of acoustic trauma. It occurs after a single exposure to very intense sound which cause damage to the organ of corti or damage the hair cells. Symptoms include ringing sensation in ear known as tinnitus and hearing loss. Treatment depends on severity of symptoms. If only tinnitus is present, protect the ear from further damage and also take some neuroprotective drugs. But, first you need to do a pure tone audiometry (PTA) to assess the severity. 1. PTA. 2. Tympanometry. Acoustic trauma. 1. Capsule Zincosule-4G (Multivitamin) once daily. 2. Tablet Defcort (Deflazacort) 12 mg once daily for seven days. Avoid loud sounds. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Can guttate psoriasis with throat soreness be treated by Humira? Patient:Hi - I suffered with chronic plaque psoriasis but have been completely clear for months now due to injecting Humira. Literally overnight, I have developed a full on rash which looks like guttate psoriasis. A week previously I had a severe sore throat for a few days. Could this be treated? Is my Humira likely to cure the new outbreak? Thank you for your help . [/INST] Doctor:Psoriasis is the disease mainly because of unknown reason. Winter occurrence is more. Disease mainly due to internal factors. And requires extensive medication with ointment and oral medication. Requires time but curable, plz upload its photo </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Q. I have gastric problems, and I puke every day. What to do? Patient:Hello doctor, I am a 22 year old male, I smoke weed and cigarettes every day, and do not eat food at the right time. So, I have gastric problems and I puke every day, from the past six months. What to do? [/INST] Doctor:Hi. I have gone through your details, and I appreciate your concern. As per the history, most likely you have severe gastritis with overlapping esophageal spasm and gastroesophageal reflux. It is because the stomach acids regurgitate back into the esophagus, causing heartburn and severe burning sensations. Dyspepsia can be a sign of gastroesophageal reflux disease. Dyspepsia can also be a sign of a stomach ulcer or gastritis, which is an inflammation of the lining of your stomach. I suggest you get an upper gastrointestinal endoscopy, to rule out any erosion of esophageal mucosa or Barrett's esophagus or ulcers. I suggest you try the following. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. If your symptoms are not relieving, please discuss with your primary physician. To be on the safe side, I would suggest getting an EKG (electrocardiography) done because sometimes atypical angina can present with same symptoms. For more 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 is the difference between oxycontin and oxycodone and can theraflu be taken in sinus infection ? Patient:wHAT IS THE DIFFERENCE BETWEEN OXYCOTIN AND OXYCODONE? cAN YOU TAKE THERA FLU WHEN ON EITHER? I AM ON OXYCOTIN AND TYLENOL AND DON T KNOW IF I CAN TAKE THERA FLU B-CAUSE LABEL SAYS TO ASK DR. I HAVE A SINUS INFECTION. THE OXYCOTIN AND TYLENOL IS PRESCRIBED BY PAIN SPECIALIST [/INST] Doctor:Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.You can take it under doctors guidance.Oxycontin and oxycodone both are same. This are narcotic analgesic. They are potent pain killer more superior than tynelol and others.As pain reliever has given you this drugs you can take this. They must be given you with proper thinking. Please do not take this therapy as this drug is addiction forming drug. You may become addicted for it if you take it for long period.You also have to take the sinus medication. I mean if you have infection than take the antibiotics and others.I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM. </s>

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

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Does Paternia treat low sperm count? Patient:how does paternia help the doctor has suggested for my husband,though after semen analysis is 48 millions spermatzoa per ml,total sperms ejaculated are24 millions pls guide about advantages & disadvantages how sooner the drug will help its been six years of marraige [/INST] Doctor:HelloYour husband's findings suggests normal sperm count.Normally sperm count should be at least 20 millions/ml.Your husband's findings suggests 48 millions spermatzoa per ml so,it is normal.Paternia is combination of amino acids,anti-oxidants,minerals etc.It contains lycopene,coenzyme Q10,L-carnitine and zinc.It is good for over all health and fertility.It may take 3-4 months to show its full effect.However,you also need proper evaluation for infertility.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: Itching skin, sore throat, coughing, breathlessness. Taking Rablet and Xaria Patient:I have a allergy of iching skin which gradually multilpies and create problems like sore throat and coughing and breatlessness. I have been taking Rablet 20 and Xaria tablets suggested by a ENT specialist for the last 4 months. But as soon as i stop it goes on multiplying again. Plz suggest a medication so that i can get rid of it. My email ID YYYY@YYYY [/INST] Doctor:This is food allergy it can be caused by anything at any age and any time of life even if you are using the food for many years Most likely to be milk but can be potato,chana,rice,egg,nuts Get blood serum tested for milk and other foods i described above Mean time stop all milk and diary no use of mustard coconut walnut groundnut and soya use olive for cooking and application on skin Take Fexofenadine 120 mg once a day for 3 week till you get answer from the tests </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes neck stiffness along with migraine and earache? Patient:I went to the ED for a stiff neck i have for two days now. 3d ago I was diagnosed with possible, bells palsy. I try to tell the PA ED that I have cervical problems and also several spinal problems. I was described Valium and steroids and send home. I am a VA dis. Vet and was wondering if i should go to VA ED to get MRI on cervical spine? I also show increased signs of MS. My neck hurts into the brain, I have Migraine history for the last two years only, off and on. I am on preventative meds for that. Neck stiffness with migraine, earache, all on left side. [/INST] Doctor:Hi I did review your condition sir.I would advice you to get an MRI of brain and neck spine done to know about this earache and headache that you are having along with neck stiffness.It can be due to cervical spondylosis or arthritis or it could be some problem within your skull bone. Another possibility is fibromyalgia but that can be thought only after a normal MRI and spine MRI.I hope this helpsWIsh you all the bestTHank you for choosing healthcare magic. </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 cough and lung infection? Patient:sir i am having cough problem from last 8 to 9 months .i i tried so many medecines but still its not cure..so please suggest me a good medicines..now a days some infuction also in my lunghs ..i am not able to drink water also..its paining..so please give a right suggessation..thankyou [/INST] Doctor:Hi,Dear,Thanks for your query to HCM.Dear I read your query and reviewed it with context to your query facts.I understood your health concerns and feel Concerned about them.Based on the facts of your query, you seem to suffer from-?TB Lungs with Chr Cough.Treatment- As your case is having cough after 9 mths of regular antibiotic?before starting any treatment-AFB sputum and PCR test for TB detection i s a must.Consult Chest Physician.Get the PCR sputum Test-to detect Pulm TB and IGRA test to detect old/hidden TB.Any other cause of the Chronic Cough - as TB pharyngitis / asthma with chronic bronchitis is to be kept in mind.Treatment would depend on the extent of the lung/or URTI infection.This would be assessed by the Chest Physician.Besides specific antibiotics/ supporting treatments likeHPBD-High Protein Bland Diet/ Plenty of fluids,Tab Zincovit -1 -to supplement the body healthis needed under expert supervision.9 mths of DOT anti-tb treatment is sufficient to take care of Tb infection in soft tissue organs.Hope this would help you to solve your health issues in the best way possible.Welcome for any further query in this regard.Good Day!!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 causes chest/back pain after having steroid injection between C7 and T1? Patient:Today I had a steroid injection between my C-7 & T-1 to relieve pain for herniated discs at C-5 & C-6. Since having the shot I am having excruciating pain in my chest & back & can t move my right arm without being in pain. The pain feels similar to a flare up of costochondritis. What could it be & should I wait it out? [/INST] Doctor:This seems to be myofascial pain which may aggravate during activity . The steroid injection will help only in the neuropathic pain. These are other components of your pain .This requires more of local pain agents such as voveran gel with hot fomentation at least twice daily.If its not settling down you have to consult a pain specialist for evalaution of any trigger points of pain . Nothing much to worry as it is only a nagging type of disease rathjer than a serious problem.You will have to take a week rest and practice good sleep habits , stress releiving habits. Get well soon </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Q. Took urine pregnancy test on the 1st day of missed periods. Is that right? Patient:Hello doctor, I have got a very regular 28 day cycle. I got my periods for three days in the last month with a heavy flow. So, my due would be today for this month. But, last three days I got very little bleeding and the color was light watery red and sometimes brownish. I did not have any physiological and systemic disease so far. I took a home pregnancy test on the first day of my missed period that is today, but the result was negative. I also have slight cramps on my lower abdomen. Please advice the reason. [/INST] Doctor:Hi. For further information consult an obstetrician and gynaecologist online --> </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes back pain with feet numbness? Patient:I have a chronic lower back problem taking medication and treatment by pain clinic. I now have problems with my feet losing feeling especially while sitting and driving pain starting in big toe. Seen specialist today and have been referred for a new one .(6.5 years since last one. I have also been referred for a nerve examination in feet and legs. Was in severe pain after examination and mind was not functioning. [/INST] Doctor:Hi,Thanks for writing in.There are 5 small bones aligned on top of each other in the lower back which are together called the lumbar spine. There are soft discs which are spongy structures between 2 bones. Nerves which originate from the spinal cord pass through the holes between 2 bones and then supply the legs.When there is overgrowth of the bones or the disc gets degenerated then it presses on the nerves and causes pain. Numbness is also due to significant pressure on the nerve roots in the neural foramina.It is required that you get a MRI scan of lower back done if you have not got one done and your symptoms of numbness and tingling are recent. This will help to know if the nerve is getting pinched in any location. The doctor will decide the treatment after going through the findings of your MRI scan. Please avoid heavy physical activity and get nerve study done as recommended. 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: What is the cause of vomiting and stomach pain in a child? Patient:Hi. My 8-year old daughter is constantly complaining of stomach pain. In the past three weeks she has vomitted her breakfast. Am I rushing her breakfast to get her to school on time? Should I consult a paediatrician or take her to a gastroenterologist? Please advise. Thanks. [/INST] Doctor:Stomach pain and vomiting may be caused due to gastritis, acidity or reflux.You may ask your pediatrician for antiemetic and antiacidity medications.If she is vomiting only before going to school, there might be possibility that she is inducing vomiting to avoid going to school. Ask her if she has any problems in school. Communicate with her teacher to know her school performance. </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,high white blood pressure and fatty liver? Patient:Hi for the past 3 months I have been getting these weird symptoms here are some been to the ER 14 times already high blood pressure high white blood cell count fatty liver sludge on gull bladder one time my white blood cell count went from 15 to 8 in two days very very fatigue sharp pains our whole body what could this mean [/INST] Doctor:HIWell come to HCMFor the last three month if you have a high white blood count and not being treated for infection then the clinical out come would have been serious but nothing like that happened and not even for other condition that is being mentioned here, in fact this is nothing to worry, because of the functional elements this might be happening, just forget about this, hope this helps. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes back and abdominal pain along with dark urine with a habit of excessive masturbation? Patient:I have been masturbating excessively for about 15years. Im 28 now. I used to masturbate up to 7 times a day. Sometimes i d do it till it hurt. 2 years ago i started having back and abdominal pains. But they came and went. I recently stopped and haven t done it in about 5 weeks. Now the pain is constantly there. I have dark and foamy urine and need to constantly go to the can. These are all signs of kidney problems. Now im even afraid to go get tested because of what they will tell me. But im pretty sure its due to the excessive masturbation over the years. [/INST] Doctor:thanks for your query in HCM,FIRST OF ALL DON'T WORRYmasturbation is a normal thing. it doesn't have any harm on your health. by your history you are urinating frequently which suggest probably you are having urinary infection. get your urine tested and get managedthank you </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Trying to conceive, have pregnancy symptoms, periods heavy, painful. Pregnancy chances? Patient:Me and my bf are ttc and we had sex on the 20th of last month. About a week after I was having pregnancy symptoms and my appetite has increased tremendously and I was expecting my period on the 7th of January but it came on New Year s Day and it was so painful the worst pain I have had in a long time and my period is really really heavy and light red with like red strings in my period and usually my period is heavy one day and it becomes light. Is it possible that I could be pregnant even though my period came early? [/INST] Doctor:Hello thanks for your query. The only reliable way to confirm a pregnancy is by taking a pregnancy test. The other symptoms are not reliable at all for diagnosis. So please do that at the earliest, so that you can be sure. Take care. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest cure for insect bite Patient:Hello My parnter is having pain on his right side underneath his appendix, He stayed a friends place last week and got bitten by an unknown insect when he was sleeping in there guest room. He know has 4 red bite marks 4 fingers above his appendix line but now it's sunday and he is have pain 4 fingers underneath his appendix spot. He describes it has tight and tender to touch [/INST] Doctor:Hi.Welcome to HEALTHCARE MAGIC.I have gone through your query and can understand your concerns..As per your complain it seems that due to multiple insect bites there has been allergic reaction as well as inflammation at the site and around the area of insect bites leading to pain and redness..There can also be swelling and itching at the site of bite..Your husband can take a course of anti-allergics like Benadryl or Allegra, take anti-inflammatory painkillers like Ibuprofen, do cool compresses over the area..You can also apply a steroid ointment over the area..Avoid scratching the area to prevent infection..Hope this information helps..Thanks and regards.Dr.Honey Nandwani Arora. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes dizziness,blackouts and nose bleeding? Patient:Most times when I stand up I feel like my head is spinning and I can't see. I also get nosebleeds for no reason, I am usually the first one to get tired (extremely tired) after physical activity out of all my friends even though they do as much as I do. What is wrong with me? [/INST] Doctor:HIThank for asking to HCMI really appreciate your concern looking to the history given here I could say that you must be having two conditions one is orthostatic hypotension and second is epistaxis both the condition are not said to be danger for the orthostatic hypotension take care while you stand up do not stand up suddenly, for the epistaxis underlying cause need to be found out, take care and have a nice day. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Which is the best contraceptive pill? Patient:I m going on birth control and I have seen a lot of mixed reviews about the different types of pills. Do you have any advice on the best kind of pill? Also, I was once on depo provera (I got one shot) then I stopped because I bled for 2 months and had no sex drive. Will that go away if I go on it again and continue with it? [/INST] Doctor:in my opinion u can take novelon or femilon pills...n can stop depo shot...birth control pills has to be taken regularly and on time...u can consult your gynecologist for pill.. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Severe itching and swelling in the labia minora due to allergic reaction to solar caine and sulfa drugs. What to do? Patient:Had an allergic reaction to sulfa. One sided labia minora swelling , severe itching, initially resolved with stopping Sulfa and benadryl . Not before I sprayed down with SolarCaine due to intolerant itching. Now clitoral area is peeling and itching like mad. Have had several peelings in the last 4 days. Anything to do? [/INST] Doctor:take allegra 120 mgm bd syp pirito 1/2 tsf night apply mometasone bd use calamine and mycoderm powder in dat keep dry clean after every piss it takes 3 week time tocome to normal </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: How contagious is Spinal Tuberculosis (TB)? Patient:I am suffering from spinal tb which was diagnosed last month...i have a 6 year old bro who eats and sleeps with me ..now i am avoiding to eat with him..what are the chances of him getting infected . I have small cousins too.and we all used to eat together..doctor says i cant transmit it but i am afraid [/INST] Doctor:I read your question carefully and I understand your concern.Your doctor is correct though, if only spinal tuberculosis without involvement of the lungs there is no risk of transmitting the infection, you are not externalizing the responsible germ.I hope to have been of help. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes ineffectiveness of Dolonex DT used for knee pain? Patient:good evening Dr. I am 58 years oldf and suffering from knee pain especially during night. Doctor has advised me Tab Dolonex DT. I have been taking this tab for the last 10 days but my pain has not gone so far. What may be reason for its ineffectiveness. [/INST] Doctor:HiDolonex DT 20mg is used to treat moderate to severe pain in condition such as osteoarthritis and rheumatoid arthritis.So 10 days of drug use should have some relief from pain.Visit your physician for prescription of another painkiller since you are not responding to the drug or the pain is very severe. Kindly check the expiry date.Hope I have answered your query. Let me know if I can assist you further. RegardsDr.Saranya Ramadoss, General and Family Physician </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What does indigestion hypertension with chills suggest? Patient:My husband has been experiencing a feeling of indigestion(uneasy stomach) and then gets chills really bad. He is 63 yrs old 6 4 (285 lbs)with hypertension(controlled), overweight, IBS, borderline diabetic, takes lisinopril. avodart and Vitamin D. These symptoms don t come at any given time, such as after eating or activity. They have occurred even while he is in bed resting or awakens him from sleeping, but there is no rhythm or reason surrounding the symptoms. What do you think this is related to? [/INST] Doctor:Hello!Welcome and thank you for asking on HCM!His symptoms could be relate to different possible causes (coronary artery disease, cardiac arrhythmia, thyroid dysfunction, electrolyte imbalance, IBS, etc.). For this reason, I would recommend consulting with his attending physician for a physical exam and some tests to investigate for the possible causes: - a chest X ray study and pulmonary function tests- a resting ECG and cardiac ultrasound- complete blood count, PCR, ESR for inflammation- thyroid hormone levels - blood electrolytes- an ambulatory 24-48 hours ECG monitoring would help investigate for possible cardiac arrhythmia. An exercise cardiac stress test would help investigate for possible coronary artery disease, especially when considering his cardio-vascular risk factor (hypertension, diabetes, overweight, age). You should discuss with your doctor on the above issues. Hope you will find this answer helpful!Wishing good health, Dr. Iliri </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What does burning sensation on sprained ankle indicate? Patient:I m pretty sure I sprained my right ankle yesterday. I can put weight on it, there is little to no bruising and the swelling has gone down a little but I have a constant burning sensation on the outter side of my ankle going up my calf a little. Is this something I should worry about. I plan on going to work tomorrow. [/INST] Doctor:Hello,Your symptoms seem to be related to the sprained ankle. I suggest using anti-inflammatory medications such as Ibuprofen to relieve the pain. I recommend to use cold compresses for local application. I suggest to use a splint to prevent further damage of the ankle.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Dorina Gurabardhi, General & Family Physician </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Q. Stress causes stiffness in my neck and back. What can be done about it? Patient:Hello doctor, I have a stiffness of neck and pain which continues to the back further. This often happens when a stressful situation arises, which also raises my BP. Worries related to health and other life concerns keep bothering me. Please suggest. [/INST] Doctor:Hello. From your symptoms, it seems like fibromyalgia with anxiety. Whenever we are anxious, our autonomic nervous system plays a role, and hence increases the blood flow to various organs by pumping more blood at higher rates, and thus heartbeats can be felt by us. Also, when we are subjected to constant stress, those muscles become stiff. And thus, due to constant tension in them, they hurt after some time because of lactic acid accumulation. Your BP (blood pressure) is also because of stress and not medical hypertension. I would like to know more about your symptoms. Let me know about the details so that I can help you further. Take care. Revert with more information to a psychiatrist online --> </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Can Nestle Pre Nan formula be given to 1.5-month-old infant? Patient:Hi, My twin baby girls are 1.5 months old (36 weeks PRMI delivery). Current approx weight is 2.7 & 3.00 KG. we are giving them "Nestle PRE NAN" to them as per doctors advice. how long do we need to continue this or should we need to change. Regards,Shailesh [/INST] Doctor:Mother's milk is always best for baby. However if it is not possible formulas can be usedPRE-NAN can be used for feeding the rapidly growing infant of low birth weight until he achieves a weight of 5 kilograms. You should strictly follow the proportion and quantity of PRE-NAN powder and water during preparation of feeds which changes as per weight of baby.For further queries you may consult me at Healthcare Magic under section "Ask Expert " >>>"Ask Pediatrician".Dr. Khan Shoeb </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes death of an infant due to heart murmur? Patient:Hi my 8 month old baby had a heart murmur and 2 weeks ago he passed away. They still doing testing on him and the last test is a brain one cos he had two seizure when he was born and they want to see if he may have had another one. What are the chances of babies dying cos of heart murmurs and having a seizure? [/INST] Doctor:a child dying of heart murmur suggests that he had a congenital heart disease and he must have gone into Congestive heart failure and succumbed(commonly seen in these conditions). If ECHO was done, that could have explained the type of heart defect in the child. If the child has Cynotic CHD, in that condition a Hypoxic event can lead to seizures. Children with CHD are prone to sever pneumonias which are difficult to treat and can lead to septicemia and Meningitis, which is another cause of seizures. Apart from these conditons, brain abscess in CCHD or any structural malformation in the brain(Syndromic baby) can also cause seizures. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Is Sensodyne toothpaste effective for my teeth ? Patient:Hi, My teeth are very sensitive to cold, sweet things. I am using Sensodyne tooth paste Is it effective ? [/INST] Doctor:Hi, Sensitivity of teeth could be due to decay, attrition or abrasion of teeth. The problem should be identified and restoration is required if the tooth is decayed. If you have generalized attrition you can use Sensoform/Sensodyne/Colgate sensitive toothpaste till your sensitivity is relieved. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What should I do for severe pain in kidney area? Patient:I have pain in my kidney area for 3 weeks when i sit it brings in on. I went to chiropracter yesterday and they relieve a pain above it which is much better now but my kidney area still hurts. No pain to urinate usually helps to lay down only last night it ached for awhile after I went to bed. [/INST] Doctor:HelloPain in kidney area need proper evaluation.It is important to know side involved.Pain may be due to renal calculus,colitis etc.You may need proper clinical evaluation and investigations.You may need routine hemogram,serum urea and creatinine,random blood sugar,urine RE/ME and ultrasound of abdomen.Ultrasound of abdomen can exclude many possibilities.It is very helpful in diagnosis and treatment.You should consult surgeon for proper evaluation.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: Taking Clomid. Positive pregnancy test. What does a 54 HCG test result really mean? Patient:I have been on Clomid the last 6 months and this month I finally have a positive preg test. I have been taking 150mg of Clomid the last two months. I had blood work done today 29 days after LMP and my HCG level is 54. My ovulation usually occurs about the 16th day of my cycle. I am a little later than the average woman - according to what I have been told. I read on the internet today and my HCG level of 54 concerns me. I will have another blood test in 2 days. What does the 54 HCG test result really mean? [/INST] Doctor:HELLO, well , you have done a pregnacy test too earlier.This is a low level HCG, and it could be a early pregnancy. Please repeat after 2 days . The level needs to be more than double in normal intrauterine pregnancy.If it doesn't, then it is a cause of little concern. 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 rid of swelling and itching of eyelids? Patient:Hello doctor, I have an eye infection for six months. Initially, it started with the left side under eye and now it is with both the eyes. Currently, my right eyelid and both under eyes has swelled. Whenever I touch or rub my eyes, also I get itching sensation. I have stopped using all eye cosmetics since then. Every doctor I have consulted says it is dust allergy and gives different eye drops, tablets and ointments and says to use it until one month continuously. I have used precisely as each doctor suggested till date but still could not get rid of my eye infection. Even now my eyelids and under eyes are swollen. Please explain to me why is this happening for the past six months and please help me to get rid of this suffering. [/INST] Doctor:Hello. Unfortunately, allergy is not a disease as much as it is a reaction to some factors. The purpose of any eye drop that we use as ophthalmologists can recommend is merely to suppress that reaction. The main treatment would be to detect the factor that is causing this condition and escape it. In order to do so, you will have to go in your memory six months back and find out what new factor has been introduced into your life. Another option would be to undergo an allergy test and find out what are the main factors you have an allergy to. It would of course help me more to visualize the changes that you currently have in the eyes. You can upload several good quality photos of your eyelids and invert them so that I can see the conjunctiva (the inner layer of the eyelids). It is very important to inform me whether you have any other symptoms such as sneezing, dry cough or any other symptoms that started at the same time with the changes in your eyes. </s>