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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 remedy to relieve back pain Patient:past 3 to 4 weeks i started having sharp pains in my back (but more to the right side), some days it was there, then would be gone the next. As weeks and days went by the pain increased, and was more daily and constant, it also starting radiating up below my right scapula, and around my right side, to my front below the right side of my ribs. I had blood tests done and an ultrasound - abdomin (upper). The doctor thinks I have shingles, but I have no rash, and the ultrasound showed an enlarged liver. my pain in now both front and back, and increases with most any movement I do (standing, walking, bending, twisting..etc). the pain is less, and more of a dull pain when laying down. my doctor gave me norco for the pain, but wants me to take acyclovir for shingles, but this medication caused my mom to have kidney failure about 3 months ago, and I'm affraid to take, since the ultrasound also shows I have an enlarged kidney to. Could the enlarged liver cause pain, by putting pressure under my rib cage, causing back and front pain when making movements. (when moving the pain is about a 7 to 9) 10 being the worst, and about a 5-6 when laying down. I heard there is a blood test for shingles, but alot of my problem, is I have no insurance or income to take a lot of test or get treatment. I feel the problem is more with my liver. I am obese, but have lost about 30 lbs since the pain started. I was at 416, and now at 386, but without dieting, with the abdominal pain, I'm just not hungry that much any more, sorry for typing so much... [/INST] Doctor:Organ involvement such as kidney or liver is much less likely to be the cause of this type of back pain. And low cost blood tests can rule out dysfunction of these organs. It sounds more muscular in origin. A course of physical therapy would help greatly. Or even local muscle trigger point injections by the doctor. Topical ice and heat are things that you can do yourself. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Does kidney cancer occur due to the exposure of asbestos? Patient:Hi, i recently found out that I had Kidney cancer and had my right kidney removed. I am a 45 years old female and don t smoke, don t drink, and I am vegan. I have always been very healthy, active and have a positive attitude. I am 5 6 and weigh 135, so I am not overweight. There is no history of kidney cancer in my family and it is not genetic. Is it possible to get kidney cancer from exposure to asbestos without having lung cancer. (or just lung problems) too? [/INST] Doctor:It is unlikely that asbestos exposure is responsible for an important increase in kidney cancer risk however high asbestos exposure might entail a small increase in risk for kidney cancer.RegardsDR DE </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest remedy for severe vomiting during pregnancy Patient:Hi Doctor My girlfriend have 3month pregnant So the problem is that she don t stop Vomiting ,special in the morning Last time she vomit a blood .I try to bought somethings. Will help her so at the shop they told me that sorry we can t sell,go to docter first so I need your help before I go to docter help me docter [/INST] Doctor:Hi I have gone through your complaints.vomiting during pregnancy is quite common in first 5 months.start Tab Doxinate plus in the morning 10-15 mts before meal.if vomiting are severe take 2 tablets also , nothing to worry.these tablets are safe.if not reducing with this medication go for Tab Vomiset .consult the obstitrician and take the further management .Thank youRegardsVasundhara </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 getting pregnant after taking ipills? Patient:Hi , I was wondering am I most likely okay if I had sex with a condom, it slipped off but my partner didnt ejaculate in me. I also took the morning after pill the next morning. Also can the pill make you late, because i am a week late and am a very paranoid person and Im freaking out although my friends say I shouldnt be ! [/INST] Doctor:Hi dear without ejaculation inside there are no chances of getting pregnant also you have taken I pill so no need to worry..if you missed your periods by 2 weeks then do the urinary pregnancy test,blood hCG levels and USG for final confirmation..that's my advise as more anxious you be it will late the periods..anxiety is one of the cause of delayed periods..stay strong and be relax..regards Dr.Sohil Takodara </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes bruises on neck,rashes on shoulders and losing the gel in between the disc? Patient:yes. thank you...i have had a bruise on both sides of my neck for about 6 or more months...i have had osteoarthritis for about 20 years & i m 51 now.the pain is more on my neck instead coming from my spine or any discs. although on my M.R.I. it shows that my discs are losing the jel inbetween. I haven t ever had pain from both sides of my neck. plus the bruises. It alson seems like my skin around my shoulders looks greenish.also i ve had all these little rash like bumps that do not itch at all.it started spreading from the back of my arms to my my thighs then to my calves. i m not sure if all this is connected or not...thank you for your opinion .. [/INST] Doctor:Hi, You are correlating different things with one another. Bruises and rashes are completely different, it has no relation with your disk space. During the loss of disc space and loss of gel, you will get pain in the back, not rashes and bruises. Thank you. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Jaideep Gaver, Orthopedic Surgeon </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Q. My daughter's cough got worse after taking Prednisone. Why? Patient:Hi doctor, I have a two-year-old daughter. She suffers from a cough for the past 17 days. It is nonproductive, and it gets worse when lying down. During night time, it comes as a dry hacking cough. The illness started with nasal congestion, and quickly, it became a cough. There is no rash, no changes in bowel movements or urination, or energy level. She has undergone tonsillectomy and adenoidectomy before ten months for sleep apnea, and it was successful. She gets this problem for the past six months. She does not have a fever. We used steroids before these events. Now, her cough got worsened for the past two days. We consulted a pediatrician, and she was given with Prednisone 15 mg two times a day and Augmentin. I gave steroids to her. She woke up in the night and had vomiting two times. She had a fever of 104 degrees. She also had congestion. I consulted the pediatrician. Currently, she takes Zofran 4 mg, Ibuprofen 10 mg, and Augmentin. Does she have a new viral infection? Why does her cough got worsened? Is it due to a progressive lower respiratory bacterial infection? Is it due to a drug reaction to the steroid? [/INST] Doctor:Hi. It is less likely to be a viral infection as the temperature is quite high. It may be a viral bug, and it can be worsened after the administration of the steroid. Do not give steroid without a prescription to the child. Do a respiratory PCR, and it helps to find the exact cause of the same. A cough may have worsened following the steroid probably, because, it can be an infectious disease to be treated by antibiotics. It may not be a drug reaction to the steroid, but possibly an overdose. Children do vomit multiple times with a high oral dose of steroids. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What medicines should I take for panic attacks resulting in stuttering of words ? Patient:HI, I have really bad panic attacks and recently can t seem to finish some of my sentences, sometimes I,m stuttering and slurring my words. This is all out of character as I am generally a confident person. [/INST] Doctor:The symptoms described by you are indicative of anxiety, which can decrease your confidence and hamper your progress. It is advisable to consult a psychiatrist as it is a very common but treatable problem </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Itchy rash near the belly button spreading. Burned scar upon healing. What are these? Patient:I had an itchy red rash to the left of my belly button that keeps spreading around my belly button. At times it gets extremely itchy and almost feels like it is pinching. Part of it has cleared up and I almost have a burn scar where the rash was. I have been putting Lanacane cream on it to help with the it. Just when I think I am getting rid of it, some more bumps break out. is there an otc cream or something i can put on it to try heal it or stop the itchiness? [/INST] Doctor:Hi...thanks for posting here.Itchy rash with central clearing and periphery spreading is suggestive of fungal infection.It always occurs where there is moist environment like groins,inner part of belly.Try to keep area as dry as possible,Use loose clothings,take antiallegic tablets at night ,apply zimig cream at night for 2 weeks, still it persists then you better consult a dermatologist and start oral medications.You can apply candid soap for wash at day time. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: How to calculate the date of conceiving? Patient:I had my cycle on May 1st, I have a 30 day regular cycle. I had intercourse on May 9, but he did not ejaculate in me. I then had sex on May 14th and 17th when he did ejaculate inside. When I had my first ultrasound, the physicians office confirmed a due date of February 6th, 2011. In your opinion, which day did I conceive? [/INST] Doctor:Hello,Physicians calculate according to your last menstrual period (LMP) then add 9 months plus 7 days to calculate the date. But if you have a regular cycle, you say your LMP is 30 May then around 14 to 17 you might ovulate and have sex during that time. Most likely it's on 14th day rupture if cycle is of 28 days. You have to check by USG rupture.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Sheetal Agarwal </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Diagnosed with nephrotic syndrome for symptoms of constant diarrhea, weightloss. What is the treatment? Patient:I have been diagonosed with nephrotic syndrome on november 28 th 2013, and the doctor that saw me in the hospital wanted me to follow up with one in my home town and the one here is so busy traveling to town to town that i cant be seen till january 8th 2014 . i am getting weaker and weaker very sick to stomach constant direaha and loosing weight and cant find a doctor to see me ...can u get me one in the oklahoma city oklahoma area.....that will see me asap....... [/INST] Doctor:Hi, Welcome to Health care magic forum. To be frank, what you want now is a physician for the treatment of the diarrhea, keeping in mind of the nephrotic syndrome. So i advise you to consult a physician in your area oclahama, showing your reports of the nephrotic syndrome. Avoid taking salt, oil, nonvegetarian foods. Wishing for a quick and complete recovery. Thank you. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest treatment for dry cough when suffering from epilepsy Patient:I am 49 year old female,4 ft 7 98 lbs.For the past week or 2,, I have had a dry cough no fever,no sore throat and sometimes my chest feels heavy. Sometimes I am able to cough up phlegm but not often.I also have been getting headaches when I cough and I have been sleeping more than usual .I have borderline diabetes and suffer with some mental health issues and epilepsy, so I am hesitant on taking anything over the counter as it might affect my sugar levels or will not react well with the prescriptions I am on now.Any suggestions would be most appreciated.. [/INST] Doctor:Thanks for your question on HCM. I can understand your situation and problem. In my opinion we need to rule out lower respiratory tract infection (LRTI - pneumonia) in your case. Because your symptoms like constant cough, chest heaviness and phlegm etc are seen in pneumonia. Epilepsy and diabetes are risk factor for lung infection. So better to consult pulmonologist and get done 1. Clinical examination of respiratory system 2. Chest x ray. Chest x ray is must to rule out lung infection. You may need antibiotics and antihistamines drugs. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest medication for frequent wheezing and mucus vomiting Patient:my son has 1 year old. often he affected veezing. i don t know how i protect him. sometime he get vomitting it is looking like a mucous. i dont t know which type of food i give him. He also looking like very leane. his weight also increase very slowly. please help me [/INST] Doctor:Hi,Although the details given are insufficient, I will through some highlights. I guess the wheezing was recorded by your doctor also. Recurrent wheezing in children is usually caused by an allergic condition called ASTHAMA. In such cases, after confirming diagnosis with detailed history and examination, I used to give inhaled medications and some oral drugs. Some children with frequent symptoms will need to take the medication regularly for few months. you can discuss this with your doctor in detail, as the diagnosis and management is a step wise process. Meanwhile take care of few tips:1. Keep his room clean and dust free2. Avoid woollen clothes / blankets / bedsheets3. Avoid playing in dusty / cold environment4. All window curtains need to be washed and dried once in 2-3 weeks5. Keep away from smoke and smokersYou have not mentioned his weight. By 1 yea,r we expect about 9 kg. If he is > 8 kgs, you need not worry. Just give him calorie and protein rich diet(include ghee, pulses, curd, egg, well cooked meet in diet).Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Muhammed Aslam TK, Pediatrician </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What does questionable PLC clumps, immature gran and NBRC in an infant mean? Patient:Hi doctor, my son had a platelet count in the reading 491 m3/ul when he is 3 weeks old The report show question mark in PLC clump, immature gran, NBRC. May i know what does it mean? But doctor said everything is ok, now the insurance company query about these. The blood test was done due to prolong jaundice. [/INST] Doctor:In case of newborn this blood picture is normal but after day by day it will be switch on to normal blood picture. So i suggest you to follow up regularly. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What are the side effects of masturbation during pregnancy? Patient:I am 12 weeks pregnant.I am with my parents now.My husband stays with me twice a week and those times i have the urge to make him masturbate me by just rubbing the clit.Will masturbation affect my baby.My first scan reports are normal and gyn dint ask me to stop sex.. [/INST] Doctor:Hallow Dear,Masturbation by just clitoral tickling will not at all harm the baby in your womb. However, I would like to give you some more scientific advise regarding sexual relations during pregnancy. It is safe to have sexual intercourse between 14 weeks to 28 weeks of pregnancy if there is no specific contraindication. Later, physical contacts become quite bothersome and also the uterus is more irritable. During intercourse in the mid trimester, full insertion of penis into the vagina should be avoided. Partial insertion of penis in the vagina also gives good orgasm at the clitoris. Intercourse in side position prevents full insertion of penis. I hope this helps you. Dr. Nishikant </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What does a lump between the knees and hips indicate? Patient:i have a golfball-sized lump on/in my hamstring half way between knee and hip. Next to it is a depression in the same muscle. The mass seems to be involved in the hamstring muscle itself. I did injure something a few weeks ago which causes deep aching inside the buttock where the muscle attaches to the hip bone structure. [/INST] Doctor:Hi, Golf-ball sized lump on hamstring, midway between hip and knee with a nearby depression after an injury can be due to one of the following reasons: - Hematoma formation - Abscess or cellulitis - Preexisting lump like a lipoma or so. This can be diagnosed by the following ways: Clinical examination by a General Surgeon gives fairly correct diagnosis. To be confirmed by high resolution ultrasonography or MRI as is needed. FNAC that is fine needle aspiration may be needed in selected cases. All these will give a proper diagnosis and a plan of an appropriate management wither surgical or medical as the need be. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. T Chandrakant </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Could redness in gums and sores on lips be due to stomach infection? Patient:hi my daughter is 17 mos and ben to the doctors 4 times they keep giving me different things that are wrong with her shes ben sick for 3 weeks now she had fever stuff up nose and cough now shes getting over those but now i see in her mouth that her gums are red and sores on her lips the doc thinks that its a stomach infection but what can i do? [/INST] Doctor:there are various reasons for redness in gums and soreness,,, e.g. tooth bite while chewing, vit. B complex/ vit. C deficiency, local infection etc. initially u should maintain oral hygine regularly and take vitamine B complex/ vit. C tablets for 5 to 6 days,,,,,, if still problem persist u should consult ENT surgon for that,,,,, </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: How to get rid of impotence? Patient:hi,i am surendra 38, iam suffering from impotence since last 1 year , for that time i was a chain smoker but not today.i do exercise from one month and i feel groin pain.my marriage life is worst. please advice what can i do for impotency and groin pain. [/INST] Doctor:Hi, You need to stop smoking completely as smoking is one of the cause for erectile dysfunction. I suggest you get checked your serum sugar level and measure your blood pressure as well to exclude diabetes and hypertension as cause for ED. If you have anxiety history than it is also aggravating factor for Ed. Practice more foreplay before sex and Tadalafil can be taken 40-60 minute before sex for short duration. If you are obese than loose weight. Intraurethral injection of alprostadil also can be beneficial. Kindly consult sexologist for detailed discussion of all these. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Parth Goswami, General & Family Physician </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest treatment for lethargy and painful cervical lymph nodes in a child Patient:HI, my 3 year old son has been ill for 9 months, it started with a virus as such. He suffers with occasional night sweats and a fever every 21-28 days. He has a poor appetite although we do make him eat, he drinks plenty of fluids. He is lethargic and tired and is unbearably tired by friday. He looks washed out and tired. The last letter from our consultant stated He has persistent 1.5cm mobile shotty cervical lymph nodes and inguinal lymph nodes present on the right side of his nec, but with no obvious hepatosplenomegaly or masses. His abdo is soft and non-distended and no abnormalities of gait or limp are present. His bloods & tests include a -ve bone scan, normal AP xray of pelvis and chest, normal abdo ultrasound. His FBC shows mild microcytic anaemia, his HB 11.9, MCV 78, Ferritin 13, with slight lymphcytosis up to 5.2 x10*9/L, but a normal film. -ve serology for toxoplasma coeliac and ANA, normal u&e, LFTS, CK and thyroid and glucose Our consultant is saying its is post viral fatigue, but after 9 months ? could this really be the answer. Our 3 year old is now hoarse and complaining of pain where the glands are swollen. Can you offer any further advice ? many thanks in advance [/INST] Doctor:Hi,From history it seems that he might be having possibility of Primary complex producing long lasting fever, generalized lymphadenitis, weakness and fatigue.He might require, Montoux test,Complete blood checking with ESR.After investigations one can have some clue about his chronic fever.Consult pediatrician and get examined.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 does this semen analysis report indicate? Patient:My semen analysis shows: Volum 2ml= colour creamy white=consistancy thin= ph 8.0= Sperm Count = 56 millions/ml, liquefaction time = 30 mins, Reaction = Alkaline, Motility : Active = 50% Slugglish = 30% Non motile/dead = 20%, abnormal Morphology= 15%. Other findings : Pus Cells 0-1 =double headed 04%= Micro head 04% = without head 04% = without tail 03% Please let me know my report is normal? Thank you [/INST] Doctor:Hi, The given sperm analysis report is perfectly normal and nothing to worry about it. The sperm count and motility are within normal limits and you will not experience any infertility problem as per this report. 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 trouble in sleeping? Patient:my 12 1/2 yr. old grandadughter goes to bed at 9pm, sleeps only maybe 15 min, wakes and lays awake 2 to 3 hours, then sleeps again maybe 15 to 20 min. Doctor has ordered x-rays and EKG, I am very conserned. Am afraid she may be afraid to she could die after seeing her mothers boyfriend having bad seizures due to swelling in his brain from time to time, What should we do to help her? [/INST] Doctor:DearWe understand your concernsI went through your details. I suggest you not to worry much. I think you should wait for the doctor's opinion before getting carried about. From the description you gave, the sleeplessness may be due to anxiety and the cause could be the that person's bad seizures due to swelling in his brain. Such a scenario, the anxiety, could be easily treated with counseling and psychotherapy. Nothing to worry.If you require more of my help in this aspect, Please post a direct question to me in this website. Make sure that you include every minute details possible. I shall prescribe some psychotherapy techniques which should help you cure your condition further.Hope this answers your query. Available for further clarifications.Good luck. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Can Clomid be taken safely on day 15 of menstrual cycle? Patient:hello, I am on clomid 50 mg and this is the second cycle. I responded well the first cycle and now this cycle there are two follicles in my right ovary but growing very slowly. on day 10 it was 1.2 and day 13 it was 1.3 and day 15 i was 1.6 so my doctor has said to take 2 clomid 100 mg from today (day 15) and she will she me next week. I wanted a second opinion is it safe to take at this stage of my cycle and will i have any side effects as it will be 2X the dose? [/INST] Doctor:Hi , How are you doing ?I don't agree with this management. Clomid is Clomiphene is hormone which causes increase in hormone which makes the follicular growth better. But it's main side effect is it will reduce the inner lining of the uterus. If this is reduced , the pregnancy chances is reduced, as this lining is needed for the embryo/ baby to get good attachment to uterus. So the better option is to have dose of hormone injections to increase the follicular size. It will be safe to increase dose of Clomid in next cycle. But by just increasing dose of tablet , problem will not be solved. Better to take hormone injection from the beginning & you will get a much better follicular response. Hope I have clarified your queries All the bestDr.Balakrishnan </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes abdominal bloating with broken ribs? Patient:This past Friday I was in a motorcycle crash in which I broke 4 lower left ribs. I am told that is just going to take time and there is really nothing I can do... I feel like my abdomen is blouted... Is this normal and is there anything I can do for it? [/INST] Doctor:Hi.Thanks for your query.This is not normal.The bloating of the abdomen with a history of an accident which has broken lower ribs indicate investigation to see whether there is any internal injury to the abdominal viscera.I would advise you the following:Be nil orally till you are declared OK on investigations. X-ray abdomen in a standing position to see any gas under diaphragm; this is the cheapest and the simplest investigation to see is there any perforation of the intestines, ground glass appearance of the abdomen in peritonitis or collection of blood.Ultrasonography of abdomen along with CT scan to confirm the diagnosis. Once the reports are there and the clinical / physical examination is normal- wait and watch. If there are positive findings , exploratory laparoscopy is then needed and proper surgical treatment instituted. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Q. My 11 year old daughter has congenitally elongated tailbone. Will it affect her as she grows? Patient:Hi doctor, My 11 year old daughter, who weighs 35 kg and is 4.10 feet tall, is suffering from pain in the tailbone. The x-ray revealed that it is a congenital elongated tailbone. The report read, coccyx shows longitudinal clefting, which appears to be congenital variation. She has been advised to sit on soft surfaces, with a pillow, since sitting on hard surfaces seems to aggravate the pain. She has to be careful about her sitting posture all the time since sitting in the wrong posture triggers the pain. I needed to know if this pain will reduce with age since she is a growing child? Or can it further increase and cause problems later? Also, can any exercise or surgery solve the problem? [/INST] Doctor:Hello. I wish you had included the x-ray with the detailed description. For more information consult an orthopaedician and traumatologist online --> </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes numbness on the knee after falling down? Patient:Hi. I fell on my knee 2 years ago and to this day it sporadically has a tingling/numb sensation. Especially when I touch it. It feels like there are vibrations under the skin. Unsure of what kind of injury it could be. There is very little pain, just discomfort from time to time. [/INST] Doctor:Hi Hope this message finds you in good health.I have gone through your complaints and understand your concern.There is delicate nerve beneath the skin on knee that is susceptible to get injured after a fall. If inadequately treated ,it results in neuroma,i.e swelling of nerve that keeps troubling.Physiotherapy,analgesics,anti-inflammatory drugs should help.A local steroid injection would be helpful as wellNothing to worry about.     I hope your question has been answered.If you have any follow-up queries,feel free to consult me anytime.Thanks,Take care,God bless. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What could cause a white bump on the tip of the tongue? Patient:hi i have a light white bump on the tip of my tongue since 5 month now and i use to get burning tongue on and off ,i have done blood test nothing was bad except by blood is 34.4 is there any thing to worry about ?? and is there any treatment ,by the way i am taken iron medication and multivitamins as prescribe by my doc. [/INST] Doctor:Hello, thank you for consulting with healthcaremagic. Actually this bump can be a small growth which has occurred because of some trauma to that area. If it does not cause any pain or bleeding then there is nothing to worry, but if it increase in size or create other problems then you have to go for biopsy of that.As it will give the results. Hope it will help you. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What was the white round worm on my son s diaper? Patient:We cloth diaper. We wash diapers about every three days. When I was prepping them for the wash I found a white round worm, with a taper tip, a black stripe on its body in my son s stool. I dont know if it came from him or not; the day I changed his diaper I didnt see anything. SInce finding the worm, we have realize that he has not poop for four days. Today he did but it was like pebbles. THis is not normal for him in any way. The last poop (coincidentally also the same diaper we found the worm) was very little, it was like he farted but poop came out also. He hasnt been sleeping well for about a week now, but we are in the middle of moving and thought it related to that. His anus has been quite red for awhile, but no worms or itching that we can tell. Could the worm in his diaper ordinated from our son, or could it have been larve in his diaper container? [/INST] Doctor:Hi,It seems that your son might be having worm infestation, mostly round worm.Go for stool test for ova and cyst.Even without testing stool you can give one course of anti-worm treatment like Albendazole.Ok and take care. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: How to treat cold and cough in a 4 years old child? Patient:case history : my son's age is 4 years 2 months, he is having constant cold and cough problems, and in the past 1 year wheezing , cold and cough along with vommiting is getting worse,so my child's pediatric doctor has suggested the following medicine, but iam little concerned, since doctor has suggested so many medicines, his esonophills count (aec)is 1530 ,esonophills(blood)is 18.seroflo 25/125 mg ,duonase nasal spray,levolin inhaler ,montek lc kid ,cepotil syrup,levolin inhaler,azithral 200mg , hetrazan syrup can all these medicines be given to a child of 4 years age for wheezing which was suggested by my child 's pediatric doctor [/INST] Doctor:Hi...Thank you for consulting in Health Care magic. Greetings from Chennai.By what you quote I feel what your kid could be having viral associated wheeze or multi triggered wheeze. I have a few questions for you -Questions:1. How many days per month does she cough or feel breathless?2. How many nights per month does her sleep get disturbed due to above symptoms?3. Does she feel breathless when she runs around or plays with other kids?4. Are the symptoms when there are seasonal changes?5. Is there any family history of asthma or any other sort of allergies like skin allergy etc.?6. Is the cough always associated with fever?If your answer is yes for any of the above questions, your kid might be having viral associated wheezing or multi triggered wheezing and I suggest you meet a paediatric pulmonologist who is near your place. Regards - Dr. Sumanth </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Difficulty in conception. Had adenomyosis. Will there be any complication if I get pregnant? Patient:I was told in Nov. 2012 that i had Adenomyosis. I have had alot of trouble getting pregnant and i just found out in March that i am pregnant. : ) I have my first appt. with my doctor in a week . I was just wondering is there anything i should be concern about with being pregnant with my first child and having Adenomyosis? [/INST] Doctor:hi, Thanks for query. congratulation for your pregnancy. Don't worry now you are pregnant with adenomyosis. study said it is difficult to become pregnant with adenomyosis. but when you get pregnant with adenomyosis don't worry some says in pregnancy progesteron level is very high in pregnancy it will decrease symptoms of adenomyosis because it is a disease of high oestrogen level. so consult your doctor and continue your pregnancy under doctor supervision. everything will be fine. take care. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Does marina coil insert cause rashes ? Patient:ihave just had marina coil fitted for medical reasons only i had this inserted on tuesday i woke with a small rash on my arms as the day as gone on it as now covered my arms from wrist to shoulder and is now starting on my legs could it be a reaction to the coil [/INST] Doctor:Hi, It could be a reaction to the coil. I would recommend you to apply topical steroid like cortisone cream on the affected areas twice daily and take anti-histaminic like tablet cetirizine 10 mg once or twice daily depending on the intensity of itching. Hope I have answered your query. Let me know if I can assist you further. 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: Recurrent head heaviness, occasional watering from nose, neurosurgeon's advice recommended. Serious? Patient:I am a 36 yr old male with recurrent head heaviness . I get occassional episodes watering from nose .An ENT surgeon has seen and recommended to consult a Neurosurgeon . What is my disease?is it a serious problem [/INST] Doctor:Hi Dr. Sreehari, welcome to H.C.M.Forum. sub clinical allergic rhinitis can cause heavy ness in the head due to sinusitis. hypertension also can cause heavyness of head. watch the relation between heavyness and watering from nose. mental tension also can cause heavy ness of head. if none of these are present, consult the neurologist. thank you. </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: What does these CT scan results indicate? Patient:I had a CT scan and the findings state: Mild decreased attenuation in the right posterior periventriicular deep white matter. Post craniotomy changes of the midline occipital region noted. May be related to underlying demyelinating process/multiple sclerosis. [/INST] Doctor:Hi,Thank you for posting your query.I have noted the CT scan findings. They are non-specific and can be seen in a variety of conditions such as ischemia (lack of blood flow to brain) and multiple sclerosis.We need to correlate the CT scan findings with your symptoms. Please get back with your current symptoms, and also why was surgery done.If needed, an MRI of brain may be required to confirm the diagnosis.I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.Wishing you good health,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad, IndiaClick on this link to ask me a DIRECT QUERY: BLOG: </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Is it normal not to feel heart beating in chest? Patient:hi i was wondering if its normal that i cant feel my heart beating in my chest i cant feel it when i put my hand on my chest and when i lay down to sleep it feels like heart pauses or slows down this wakes me ip and the heart starts pounding. I have had an ecg which was normal but it wasnt a 24 hour ecg and this only seems to happen at nightl i have very low blood pressure as well. Is this anxiety related [/INST] Doctor:Hello, It is normal not to feel the beats of the heart. Seems more like anxiety, since you have the feeling of heart pauses and than you get scared, and because of that your heart starts pounding. Anyway, you can do a 24h ECG Holter monitoring to see if there is a problem and to calm yourself down. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Anila Skenderi, General & Family Physician </s>

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

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes difficulty in conceiving? Patient:Hi Doctor, I m 27 years old and weight 57 kg 5 6 height. No medical issues.for the last 4 years we are trying to get pregnant. but this doesnt happened yet. Husband got low sperm count around 5 million. Took some injections and count came to 18 million. Once we did IUI but didn t get conceived . I would like to know what all precautions should I take after intercourse on Ovulation. I m working and my husband drops me to office everyday in two wheeler. Is travelling can be an issue or anyother food routines that I have to follow inorder to conceive? I m a keralite. [/INST] Doctor:Hi, first of all I want to know regarding your reports if everything is fine. Then what was the motility of sperms and morphology also. You can try 3 to 4 cycles of IUI. Travelling is not an issue. Have a healthy diet. You should be in contact with your husband for next 2 to 3 days of ovulation. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What is the normal dosage of Depakote to control bi polar tendencies? Patient:my husband had been put on lexapro which caused him to becme hyper and eventually manic due to lack of sleep. He is 58 and has never shown bi polar tendencies before. They have diagnosed him as bi polar and put him on depakote. He has been on it for 4 days now and has been stable all four days, he seems like his normal self. They have decided to increase his night time dose to 1000 mg not sure why and they are not answering my questions. So he is on a total of 1500 mg's total a day. What is the normal dosage for this type of medication. Why would they increase his medicaton when he seems level and fine? He is a new patient to them so they don't know what is normal for him. His personal care physician wants me to get a 2nd opinion when he is released from the psych unit he is at right now. [/INST] Doctor:Hello,The standard dosing for depakote is decided on basis of weight of patient. Its dose is in the range of 20-30mg per kg of body weight and average being 25mg/kg.The higher the dose, the more monitoring of side effects would be required.Thanks. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Is surgery needed for the spinal stenosis with severe protrusion? Patient:I have had chronic back pain for almost a year now and come to find out I have spinal stenosis and severe protrusion of my L5-S1 disc. We have tried several weeks of therapy including traction and extensions and the pain is getting worse. Do you think I will have to have surgery? [/INST] Doctor:Hi,thank you for providing the brief history of you.As mentioned by you, you have been diagnosed with CLBP with Spinal stenosis you need to undergo a careful physical therapy. Also, depending upon the symptoms the treatment is always Planned. As in my clinical practice, even with the CLBP and Spinal stenosis, we are able to get 99% of the mobility in patients with minimal pain left, for which a regular exercises are recommended. Also, extension exercises are avoided to exaggerate the pain symptoms if the pain is increasing with the extension exercises and traction. Also, what we do initially in our clinic is medication and understand the pharmacokinetics of the drug first and the fitness level of the patient. Later we focus more on the core stability and pelvic floor strengthening. We even focus on lower limb strengthening as a whole. Strengthening the gluteus muscles helps to stabilize the spine, as the whole body weight falls on the lower spine, the muscles of the hip are important to provide the base of support. Understanding the normal biomechanics and pathomechanics of the patient we deal accordingly and every patient a different therapy.Sometimes, for pain management, we use TENS therapy, Therapeutic ultrasound therapy and Myofascial release technique,Also, exercises are totally depending upon the pathomechanics and needs a careful attention. Extension exercises and traction are usually not advised by us to avoid the movement of the spinal stenosis.We deal mostly with - TENS therapy, Therapeutic ultrasound therapy and exercises.But if the symptoms of pain is not bearable by you and leading to severe lower limb weakness, than a surgery will be advised. But my clinical practice has allowed to save 100% of my patients from surgery.RegardsJay Indravadan Patel </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes lump formation after mole removal? Patient:I had a mole removed from mt thigh 3 weeks ago,biopsy showed non cancerous irregulaties, area is very bruised after surgery,stiches have been removed 5 days ago, area now is very lumpy,is there any need for concern.any information would be appreciated [/INST] Doctor:Hi.Thanks for your query and an elucidate history.The lump may be due to an infection/ antibioma formation/ as a reaction to something giving rise to large granuloma formation/Consult the Doctor who operated and he would examine you to decide the reason and guide you accordingly,. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes flatulence building up in liver area? Patient:I am male, nearly 53, have had fatty liver for ten yrs or so, i drink regularly but not excessively, mostly wines, and eat healthily, salads, cereals, fruits, fish, very low meat and fats. Exercise at least 4ties a week, mostly swimming, live in warm climate. Have flatulence that feels like it is building up in liver area. What should I do? [/INST] Doctor:Hi,For flatulence you can take a proton pump inhibitor like Pantoprazole. Try to walk daily for 30 minutes. Eat less fibres in diet, as fibres in diet increase flatulence. A normal diet should contain no more then 30 gram of fibres per day.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Ramesh Kumar </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What treatment should be taken to cure acne ? Patient:i ve acne and spider veins on my cheeks . There are also scars left by acne. I m a 21 year old woman. Plz help [/INST] Doctor:Hi! Welcome to HealthcareMagic forum, Treatment for acne and acne scars are two different treatment.First get your acne treated .Once you are through then go for scars.Treatment for acne depends upon the stage of acne.Selection of right soap or face wash is most important .You should not use oily soaps.Use dermadew acne soap once daily.Apply nadoxin cream topically over the lesions once a day.Take tab Azithral(500mg) once daily for 5 days(1hr before food).Drink 8-10 glasses of water daily.Take good 7hr sleep.For scars you can go for lasers like fractional laser which is the latest of the lot.If its mild then even dermaroler is ok.For spider veins you have to go for lasers again and its a different laser than that for acne scars.You can go for 532 nm q-switched laser or long pulsed Nd:yag laser or a PDL(pulse dye laser) laser which is the specific laser.Some doctors even do electro cautry for the same.If you can tell me where you belong to ,then i can guide where to consult for all the three treatment. Take care, Dr.Chawda </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest treatment for back pain and feeling for urinate frequently? Patient:I am having severe pain in my mid back on the left side. It gets extreme then the reduces slightly, but is constantly there. This happened on Monday, but was fine Tues & Wed. The pain came back again today. I also feel like I have to urinate constantly. [/INST] Doctor:Hello,I had gone through the case and found that it might be due to renal stone or urinary tract infection.So go for ultrasound of lower abdomen and urine test to find the exact cause.After that take treatment.Hope my answer will be effective for you.Thanks </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest treatment for fever and sweating in case of pleurisy Patient:my fiance has had a fever for 9 days now. He was diagnosed w/ pleurecy. he has terrible chills, swearing profusely & now he's ONLY sweating on the right side of his body. Literally. HIs left side is completely dry & his right, even his arm, is soaking wet. He's on antibiotics & they're doing nothing. [/INST] Doctor:Thanks for your question on Healthcare Magic.I can understand your concern. In my opinion, you should definitely consult pulmonologist. He is having sweating and fever despite of taking antibiotics. This is suggestive of worsening pleurisy.So he should get done chest x ray to rule out pleural effusion and pneumonia (lung infection).So consult pulmonologist and discuss all these. Hope I have solved your query. I will be happy to help you further. Wishing good health to your fiance. Thanks. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Should i be concerned about the floated clot on wisdom tooth area? Patient:Hi:I had a wisdom tooth removed a week ago. I had a lot of pain for the first few days but, over time, the pain decreased. I think that the clot formed well (it was red and gray/white; I did see a bit of black very deep down, in the center). I have been very careful and using the rinse my dentist gave me and keeping the area clean.However, tonight when I rinsed my mouth with salt water with the syringe that was provided to me, I think I saw the clot float up on the water as I rinsed. I stopped immediately and believe that the clot or part of the clot settled back down in the socket. Should I be concerned? I'm not really having a lot of pain (just the minor remaining pain I've been having as it heals).Thank you so very much! [/INST] Doctor:Hi.Welcome to HEALTHCARE MAGIC..I have gone through your query and can understand your concerns..As per your complain as you have found the clot floating in water inside mouth you should immediately consult your dentist and get evaluated as if the clot gets dislodged the socket will remain unhealed and there will be development of DRY SOCKET which is a painful condition and the socket will remain unhealed..In case if the clot is dislodged the dentist can place Zinc oxide eugenol dressing which has to be changed every alternate day for initiation of healing and has a sedative effect so pain will also be subsided..Hope this information helps..If you find the answer helpful please give me a Five Star Review and click on found the answer helpful as a token of appreciation..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: Deep big hole in teeth, gums beneath tooth visible. Pain and bleeding when food stucks.Will operation hurt? Patient:I ve had this fairly large hole in the back side of one of my back teeth for over a year. It s gotten a little bigger over time and used to get sore once in a while, but I almost never feel any pain from it unless something gets deep inside it. It s large enough that some of my gums below the tooth are exposed. I only chew on my right side because sometimes food gets caught in the hole and I get it out asap. It only seems to bleed if it gets poked, and it s not a lot. It s really annoying and honestly very embarrasing, but I ve had some horrifying experiences at the dentist and I m so afraid to go. I know it is something that I need to do and will be a huge relief but I m not sure what to expect ,..is the operation gonna hurt much ??!! T_T [/INST] Doctor:hello, the condition you had described seems to be deep proximal caries in your tooth with gingival polyp in the cavitated region.. its good that you are cleaning your infected tooth properly but you need to consult a dentist soon... as your chewing on one side will harm your jaw joints.. your past experiences might be bad but now a days with lots of advancement in technology the dental treatment has become very comfortable too.. the treatment options for your tooth involves- removal of carious lesion , gingival polyp and root canal treatment of the involved tooth .. you can take anti-anxiety medicines prior to dental appointment or can also opt for conscious sedation.. dont worry about pain.. your problem will stop as soon as your tooth gets treated.. IOPA radiograph is needed to check for any periapical pathology that requires special treatment like surgery.. Root canal treatment is simple procedure where infected pulp within canals is removed, tooth is cleaned from canals and is refilled till the tip of the root apex.. dont worry.. meanwhile use antiseptic mouthwashes and brush twice daily.. 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 infertility Patient:Hello. I am concerned about infertility. I am 5 foot 2 inches and I weigh 270 pounds. I also have a history of PCOS. Me and my husband have been trying to have a child for 6 months, with no luck. I know I may be impatient, but what are my chances of infertility, and what could I do to become more fertile? [/INST] Doctor:HAI WELCOME TO HCm.you have to reduce your weight to conceive-.PCOD IS AN METABOLIC SYNDROME Which is aggravated by obesity.to get success in IVF programme also need weight reduction.consult an infertility specialist </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes painful lump below breast line? Patient:I am a 32 year old female, 5feet 5.5 in talls. I have a lump in the center of chest about 1 in. below the breast line. It measures approximately 1in by 1in and is visable if I am lying down. It is not tender to the touch however I have be feeling a sense of fullness in the area, along with discomfort and some dull pain. I do not know how long it has been there I just discovered it about a month ago when I was feeling uncomfortable in the area. I do seem to get a strange feeling when I run or do any exercise. Past medical history of left ACL reconstruction and a compression injury to lower back 16 years ago. Should I be worried? [/INST] Doctor:Hi,Dear,Thanks for the query to HCM. I studied your problem in depth and I understood your concerns. Cause and plan of Treatment-In my opinion on the given data,you seem to have xyphoidalgia-painful xyphoid bone just below the breast line,just down in the center of chest.You just have a fullness in the area and no lump even on lying down,but is painful on pressure,with dull ache pain.I would advise you to Consult ER Surgeon, who would treat it with anti-inflammatory x 5 days time / or with Voltaren(OTC)gel locally for 5 days time to control the pain.This would resolve your painful lump issue.Plz check out with your ER Surgeon who would treat it accordingly.So don't build up wrong concepts and self medicate your self which would increase risks and costs to you.Instead just ask a query to HCM and be comfortable to resolve your health issues.Welcome for any more query in this regard to HCM.Write good reviews and Click thanks if you feel satisfied with my advise.Have a Good Day.Dr.Savaskar M.N. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes sore and fissured tongue? Patient:My symtoms ARE AS FOLLOWS: SORE TONGUE WITH FISSURES ON TOP OF TONGUE AND A GREAT DEAL OF REDNESS ON SIDES. i'M A 71 YR. OLD FEMALE ABOUT 6 MONTHS AGO IWAS FITTED WITH A MOUTH PIECE TO HELP MY SLEEP APNEA AND SINCE THEN THE CONDITION WITH MY TONGUE HAS DEVELOPED. DOES THIS HAVE ANY CORRELATION? [/INST] Doctor:Hello and Welcome to ‘Ask A Doctor’ service.I have reviewed your query and here is my advice.I have read your query and understand your concern. As far as soreness and redness of tongue are concerned this can be due to the sharpness of appliance you have for sleep apnea or due to vitamin deficiency.For this I will suggest you a few measures Do warm saline rinses, you can apply lignocaine gel on the tongue. Eat green vegetables in your diet. Take multivitamin by consulting with the local doctor.Consult you oral surgeon for the clinical examination of mouth appliance for sharpness or surface roughness is present.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Priyanka Tiwari </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: How can a polyp in the anus be treated? Patient:I have a mushy type polyp on the anus. I was told today that I have the herpes virus 2. I am going to my GYN. I tested negative for HIV. I noticed a small bump. On my anus and it has grown it doesn't bleed. I had diarrhea most recently and it burned. Now when I defecate it doesn't burn. Do I go toa Proctologist? Is this related to my herpes? It has been on my rectum for a few months but in last week and a half it has grown. I can lift it out of the anus and squeeze it. [/INST] Doctor:Thanks for your question on HCM. I can understand your situation and problem. Yes, you should definitely consult proctoscopist and get done proctoscopic examination of your growing polyp. Herpes infection can be the cause for your polyp. You need surgical removal of polyp and histopathological examination of polyp to rule out malignancy. If not treated surgically then it can grow further and cause Constipation, infection or bleeding. So better to get done proctoscopic examination first and if needed surgical correction is needed to avoid future complications. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: How to get rid of gay habit/nature? Patient:sir, i am madhan from pondicherry...........i am a gay.......i want to become leave from this gay habit................i want to marry a girl and to live normal life as my parent likes........................but i do not have any desire about girl......................please help me is there any treatment for gay [/INST] Doctor:Hi,Thanks for writing in.If you have discomfort regarding your sexual orientation, visit a qualified psychiatrist. With proper advise and therapy, you might be able to come to terms with yourself and this might help in alleviating the discomfort.Hope this helps,Dr A Rao </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest treatment for wound in nose and lips Patient:my 3yr old granddaughter picked her nose and just had a tiny cut inside a week ago but it has now spread all over her nostril and onto her lip and is brown in colour! What should I apply or do for her and what is it? Ive been putting germolene on so far. [/INST] Doctor:Dear parent, this is most probably a herpes simplex viral infection. you should apply an antiviral ointement 3 times daily as acyclovir . this is contagious so avoid kissing and hugging the child until it resolves </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What is the grey substance in child s urine? Patient:My three year old son uses the potty. I noticed a linguini-like, grey substance floating in urine. It is about 15 cm long, 5 mm wide and 1mm thick. Could it be part of a parasite? I have removed the sample and put it in water. Our clinics will be closed for two days. Could it preserve long enough to be analyzed? [/INST] Doctor:Hello,Most probably it is a parasitic worm. It is better to do the test for the sample as soon as possible. If it is not possible, then please put the sample in a tightly closed container in the fridge.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Salah Saad Shoman </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest treatments for syncope Patient:What is Syncope event and how dose this effect a person and the family? HOW DO WE HELP OUR LOVE ONE ON A EVERYDAY LIFE . THANK -YOU Dr Samuel. N. Grief. What is the best treatments for someone with this fainting event? Are there other symptoms we need to watch out for? Thank yo Mabel Larkin and Teresa Hopkins. email address is YYYY@YYYY [/INST] Doctor:Hi, Syncope is the sudden loss of awareness resulting in a brief loss of consciousness. This is commonly referred to as fainting. Syncope must be diagnosed as to cause such as excessively low blood pressure, cardiac arrhythmia, lack of proper diet and hydration, side effects of medications, and other things. You should have a doctor exam your loved one in order to systematically rule out certain conditions before treating. I recommend a doctor's appointment as soon as possible for the patient. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Dariush Saghafi, Neurologist </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest treatment for lump in the fold of arm Patient:i have noticed a smaller than pea sized lump in the fold of my right arm, where you normally have blood taken, the last time i had blood taken was around 5 months ago. the lump is not painful and you can move it around when you touch it, howerver my arm does feel tingly and kinda warm. what could this be? [/INST] Doctor:hi.based from your description, it could be a simple cyst or an inflammatory process. do you have any history of insect bite or sting prior to that lump?a consult with your physician for physical examination is recommended. management (medical or surgical) will be directed accordingly.hope this helps.good day!!~dr.kaye </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What does a lump on testicles imply? Patient:We just noticed a hard lump about the size of a pea in the skin below one of my boyfriends testicles. It doesn't float around and seems to be attatched to the skin but isn't painful. Any ideas on what this could be? He is 36 years old, 6' tall, and about 220lbs. [/INST] Doctor:Hi, Your boyfriend having hard nodule over attached skin over testes. You should consult a nearby urologist for a detailed examination of a nodule and check whether it originates from skin or from the scrotum. It can be fibroma like lesion. It's advisable to investigate with FNAC to do further workup and to rule out the nature of the lesion. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Parth Goswami, General & Family Physician </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest myrsa antibiotic dosage Patient:Hi, my friend was recently diagnosed with having myrsa, a staph infection.. He was put on an intravenous antibiotics when initially diagnosed, along with taking an antibiotic in pill form. My question is how long after starting antibiotics is he still contagious? [/INST] Doctor:Hello,I understand your concern.I am Dr. Arun Tank, infectious diseases specialist, answering your query.MRSA us the methicillin resistant staphylococcus aureus..This type of bugs are resitant to routinely prescribed antibiotics.Vancomycin is the choice of drugs for such a bugs.Such a patient are contagious to others if other uses their belongings like napkins, towels handkerchief etc.Once the gross infection is treated by the vancomycin, mupirocin is used to clear up the residual flora.Once the patient is all clear up with the mupirocin they are free of their contagiousness.I will be happy to answer your further concern, you can ask me on bit.ly/DrArun. Thank you.Dr Arun TankInfectious diseases specialist. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Can a painful lump caused by surgery be treated? Patient:hello i had key hole surgery about a month ago, but i have noticed on the right hand side under the scar there is a lump, which is getting bigger and more painful, you cant notice it as much when your lying down but when your standing up its more noticeable and more painful specially as you walk, it has got bigger these last few weeks. just wondering what i should do? [/INST] Doctor:Hi,Welcome to HCM.That lump could be a hernia from the incision site.And if its causing pain them its contents could be getting obstructed.You need to show it to your surgeon for a clinical evaluation and further management.Regards,Dr. Ashish Verma </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Can stents in the heart cause anemia and tiredness? Patient:MY HUSBAND IS A 69 YEAR OLD CAUCASION,HE HAS A DEVINCI PROSTECTOMY IN 2008 WITH WONDERFUL RESULTS. THEN IN 2010 HE HAD TWO STINTS INSERTED IN HIS HEART, 95 % BLOCKAGE IN THE WIDOW MAKE ARTERY.. ALL WENT WELL AND HE HAS HAD A GOOD LIFE, BUT ALL OF A SUDDENHE HAS BECOME ANEMIC AND IS EXTREMELY TIRED. HE IS TAKING PLAVIX, CONIDINE AAND BLOOD PRESSURE MEDS, ALSO PAXIL.. COULD ANY OF THESE PROBELMS BE CONTRIBUTING TO THIS ANEMIA?? [/INST] Doctor:hi dear.good job at taking care of your husband. i will suggest you to get a complete blood test done including iron profile with perpherial smear to find out the cause of anaemia. meanwhile you can give him tab livogen once a day for 3 months. consult your docter for any other meds. if he is feeling very tierd then kindly get a cardiac consult. hope my answer helped you. please do rate my answer </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Mother died of oral cancer, oval shaped sore on floor of mouth, canker sore or cancer ? Patient:im 15 years old, on jan. 13 my mom died of oral cancer , a few days ago i found an ovel shapped pipmle like sore on the floor of my mouth . It stared to burn and itch really bad, i did research and it is most likley a canker sore , however i still have a feeling at the back of my head about oral cancer. I know that is very rare, but i just need to be sure can you please help me, please [/INST] Doctor:in view of you are young and in this age its rare, most likely it would be apthous ulcer,. You should start multivitamin and apply antiseptic jelly(hexigel ) it would resolve by itself. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest treatment for shoulder fracture Patient:I am a 75 yr old female in good health. However I fell & injured my shoulder. After a week (last Friday) I went to the Orthopedic Dr.(the PA.) I had Xrays & a tiny fracture, possibly two was found. I have to rest except do the pendulum exercise only & go back in 2 weeks. Then it will be decided if I am to have an MRI to see if the rotator cuff is damaged as pain is in the muscle at the top of my arm too. I cannot lift my arm up unless I support it with my other arm . I have been icing the area, but forgot to ask if I should continue with ice - or use heat at this stage. Can you please advise if ice or heat is better? Thank you. [/INST] Doctor:Now it has been almost two weeks post injury so continuing with ice will not help.You can use the warm fomentatio taking care not cause thermal injury to the local skin.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 does kidney function test abnormal mean? Patient:My husband kidney function test is abnormal according his family doctor . He has seing a nephrologist and all she told me infront of my husband that there is so much protein in his urine. Now another doctor took a test and he said that his kidney function test abnormal. Don t know what he means . [/INST] Doctor:Thanks for the query.The function of kidney, is the remove toxins from our body and to maintain the fluid balance. Two basic parameters are used to assess the kidney function - Urea and Creatinine (some use Blood Urea Nitrogen). If these are abnormal renal function is said to be impaired.Proteinuria (or albuminuria i.e. a condition when protein is excreted through the urine) can occur in kidney dysfunction.In this case I would like to know the following:1. The age of you husband.2. What are his exact urea and creatinine levels, and what is the quantification of his proteinuria2. Whether he suffers from any comorbidities like Diabetes or hypertension (both can lead to kidney dysfunction).3. Whether he has any symptoms like fever, burning during urination or urinary frequency/urgency/retention. These are symptoms of Urinary Tract Infection, which can lead to renal impairment and proteinuria. Whether he suffers from Prostatomegaly.4. Did he have any similar renal impairment in the past?5. Whether he has been on any drugs like NSAIDs (i.e pain killers) for a long time At this stage I would advise you to get a USG of Kidney/ureter/bladder done to check for any abnormalities like renal parenchymal disease. If you can provide any information about the above points then probably his underlying cause for renal impiarment may be detected. It is also advisable that you get his urea, creatinine and electrolytes (potassium, sodium) repeated and consult your nephrologist along with the USG report. If there is a chronic renal disease (due to diabetes/hypertension), ACEI/ARB drugs may be started for proteinuria.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 gupisone recommended for sciatic pain? Patient:hey, i have back pain, some doctor told me after checking, that its called sciatica pain, but i got some injection, and taking many medicines, but still i am not felling any difference in my self, now some one told me that you take gupisone, is it good for this pain, as i know it is setoriod [/INST] Doctor:Hi, Why you are thinking to use steroid.If you have sciatica you should be investigated (including MRI) rather.Consult a spine surgeon/Orthopedician /Neurosurgeon get evaluated. If problems are severe you may require surgery , otherwise doctor will tell correct conservative management. Regarding role of steroids in sciatica they are better use as local injection in selected cases. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest treatment for pain in left upper quadrant after fall Patient:I fell two years ago and had a lot of pain in left upper quadrant. when I lift some thing heavy the pain comes back stays for days. It hurts really bad when I sit or take a deep breath. I also pass a lot of gas and then seem to feel a little better. phyllis [/INST] Doctor:Several features of pain can be helpful in clarifying what is going on and the next steps for diagnosis and treatment. Type of pain. Burning mostly means a nerve is having problems. This can be either a sick nerve or a nerve that has had an injury. Electrical, shooting would be others implying nerve source for pain. Ache and pain with movement implies muscle and pain with gas implies bowel.Location of pain. There is a lot to this. First, if something goes in the pathway of a nerve, then that is the nerve involved. Nerves are long and the pain is in a belt-like long pathway. Smaller areas are smaller nerves. This also tends to say what might be going on. Obviously if there was an injury to the area and then there was pain outward from it "hit a nerve" would be a possibility. Sick nerves are MULTIPLE areas and tends to be the TIPS of the nerve not the whole nerveWhat hurts. Moving a particular way that triggers the pain tells what is hurting. Specifically it can distinguish outward structures like skin, muscles, tendons, joints from deep structures like organs and nerves.``     Having a diagnosis leads to choice of medicine for the pain. Inflamed outer structures respond to treating inflammation. Inner structures need diagnostic tests because something internal is broken. MRI's.And, structures that cannot be fixed need adaptations. Physical therapy, pillows, supportive structures internal and external. And graded increasing activity to get the area used to moving and getting used to the pain. BUTthis can be hazardous in some situations.For example, personally I have a break in the abdominal wall muscles. Gut can pop out of it. Straining will make it worse and make it required to get it fixed with surgery. Yeah, it fits with muscle and abdomen. I think it's the only thing that does. So, surgery would be the answer. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: How can anxiety be treated? Patient:my daughter has feelings that her family is going to leave her. she can not get rid of these thoughts even when her family tells her that they will never leave. she also worries that someone is going to take her children away from her she is taking lamictal, kepra and latuda. could these be the cause of her problems. [/INST] Doctor:Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. The provided symptoms are due to paranoia. Paranoia could be due to many psychological illness like paranoid personality disorder or schizophrenia. I suggest you consult a psychiatrist in person for diagnosis and treatment. 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 causes urinary incontinence in a child? Patient:My question is... I have an 8 year old step daughter that appears to be going through puberty. Fairly large amount of pubic hair and breast development. She also complains of a stomach ache and urinates frequently in fact she will empty her bladder before leaving the house and return for a second time for what she calls a double check . She also has problems with urine leakage with laughing playing etc. Her urine showed trace protein and ketones. What could be going on? [/INST] Doctor:Hi,Since there can be many causes of urinary incontinence in children.like nerve injury, neurogenic bladdder, or overactive bladder, diabetes inspidus and diabetes melitus.But from your daughter's history it seems that she might be having juvenile onset diabetes.I would suggest that get blood sugar level fasting and random both and urine osmolarity test to rule out the cause.Then you may further discuss with endocrinologist.Hopefully my answer is helpfull.Regards,Dr.Maheshwari </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest treatment for pain and congestion in the body Patient:I am male 31 years old. I have been having pain in the upper right back behind and below rib cage. I have dull pain all the way to ears. i feel congestion and stuffy in my right chest area and throat. I had some swelling on the right side of my neck and below my right eye a couple of days. my appetite has gone down. [/INST] Doctor:Thanks for your question on Health Care Magic. I can understand your concern. In my opinion, you are mostly having upper respiratory tract infection (URTI). But better to rule out lung infection like tuberculosis in your case because you are having symptoms of decreased appetite, stuffy feeling in right upper chest etc. So get done chest x ray first. If chest x ray is normal then no need to worry for lung infection. You are mostly having simple URTI. So avoid stress and tension. Avoid oily and spicy food. Avoid junk food. Avoid hard to chew food. Drink plenty of fluids orally and keep yourself hydrated. Start antihistamines and anti inflammatory drugs. Do warm water gargles 5-6 times a day. You will mostly improve in 1 week. 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: Is Tylenol sufficient for loss of cervical spine curve? What can help with occipital headaches and ischemia? Patient:This is Jill Behnfeldt - Initial Contact 12-8-2013 Images available also have lost my cervical spine curve. And have a 3mm herniation at C3-C4. And I have awakened to a numb right ARM, from Elbow to fingers - but resolved in less than 24 hours. I can control my occipital headaches by controlling my neck movement. Only medical treatment is Tylenol 500 mg I take 4000 mg daily. My cervical MRI is available at the same facility as my Thoracic MRI and Lumbar MRI - I signed a waiver so any physician can request them. Thank you very much. Symptoms include occipital headaches, Microvascular Ischemia - per Neurology at Univ of Toledo in 2009, I have most lesions in Centrum Semiovale and PONs areas. I do not have memory issues, nor am I having dizzy spells too frequently. Maybe monthly at the moment. YYYY@YYYY [/INST] Doctor:Dear Jill, ischemic event happens due to chronic desease such as hypertension or diabetes so you have to explore further.Anyway an daily aspirin should be added to your medication to prevent new ischemic events.Your cervikal pain can be reduced with use of NSAID (ibuprofen 400mg three times a day).Anyway you should take contact with a neurologist for further treatment.Hopping my advice will help you wish you all the best.Dont hesitate to contact me for any inquiry </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes poor weight gain in an infant? Patient:brest fed is not enough so i am giving farex formula to my baby 5 month old but she is not gaining weight iam giving 60ml for 2 hrs once. she is not awake in night time what shold i do for this iam worry about my baby weight. born weight is 2450 kg anf now 5 kg [/INST] Doctor:Hello. I just read through your question.I understand your frustration with the feeding of your baby. I want to reassure you, however, that the weight that you report is not abnormal. We expect babies to double their birth weight in the first four to five months of life. The numbers you report indicate that your baby's birth weight has doubled. Typically, we recommend beginning baby foods at this time in a baby's life. Adding baby foods can potentially have a positive effect on your baby's weight. I recommend consulting with your doctor about your baby's diet. However, I again reassure you that the weights that you report are normal. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes tiredness in a child? Patient:Hi, my 12 year old son is tired all of the time... just lacks energy. We started homeschooling 6 months ago per his request... he is advanced academically and this works well for him. He has friends he see, plays sports, doesn t seem depressed. could this be puberty? He gets 10 to 12 hours sleep. [/INST] Doctor:HiWelcome to the HCMI understand your concerns but don't worryIt seems to be due to pubertal changes. Ensure a good healthy diet and plenty of fluids. Also, some exercise and outdoor sports will be of help. Rule out anemia by hemoglobin levels.Take care </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Extremely low WBC count, very healthy otherwise. Can I donate my kidney? Patient:Currently I have been told that i have a VERY low WBC - below 1.5.. Doctor suggested I see a hematologist - please note that I do not have very good health insurance. Plus, I have always been very healthy (not even getting flu ). My question is, my sister is in need of a new kidney , would I be considered a candidate for kidney transplant with such a low WBC? Thank you for your help. [/INST] Doctor:the lower limit of normal wbc count is 4000/cmm & you have only 1500.at first it should be evaluated properly.have you any recent history of fever,drug ingestion.repeat the WBC count,if it is same then consult with a hematologist. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest treatment for blackheads in ear canal of a child Patient:How do I remove five small blackheads right in the beginning of the ear canal of my five year old? They have been there since she was two. Doctor said to just leave them alone. They don t bother her it s just when she is wearing her hair pulled up it is noticeable. [/INST] Doctor:Hi...you need not worry as the blackheads are not creating any problem for your kid. To be frank they might cause disfigurement if you try to remove them. So please do not venture about removing.Regards - Dr. Sumanth </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Can you suggest some treatment for acne on my back Patient:creams for body acne ....i have acne on my back which looks so bad and ugly .....please suggest some home remedy or cream for the acne to clear without any marks [/INST] Doctor:Hello, Thanks for posting your query. Home remedies to clear marks would be tomato which you can apply leave for about one hour and wash later. even Tulasi leaves and pudina also acts in similar way. Drink more water and maintain good hygiene and diet rich in fruits and vegetables. Hope I have answered your query. Wishing you good health. Regards, </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Can MX3 capsule or tea help cure hormonal imbalance? Patient:hi doctor. can mx3 capsule or tea help in the cure of hormonal imbalance? I m having menses for 17days now due to progesterone withdrawal symptoms.i underwent oophorectomy due to endometriotic cysts.i was injected w/ high dose progesterone for 3 months. had no menstruation for 2 months.then when it recurred, i had my menses every 2days.i was advised by my dr.to take oral progesterone but my menses didn t stop.thanks! [/INST] Doctor:HiMX3 capsule or herbal tea may not be sufficient to alter your hormonal levels.Progesterone containing pills are essential to restore your normal cycles.Kindly rule out other causes such as hypothyroidism or anemia which can also cause hormonal imbalance.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: Q. Is alcohol bad for hypothyroidism? Patient:Hi doctor, I noticed that, after drinking alcohol, I feel exhausted and weak, after a week. I also have pain behind my eyes and a constant headache. I am curious if it is related to the thyroid or something else. Does alcohol affect patients with hypothyroidism? [/INST] Doctor:Hello. I just read your query. Hope my advice is of some help to you.  For more information consult an endocrinologist online --> </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes elevated AST level? Patient:22 year old femaleworkout 3x/week125 lbs 5'5 1/2"rarely drink (4 drinks in 6months)Elevated AST of 93 (normal I was told from the doctor is 14-36)BP was 110/70 ..again lowI have been very tired lately and have had a migraine that is onset within the first hour of waking the past 4 days.I have GERD and take omeprazole once daily, however havent taken it 4 days prior to my appointment due to packing it away after graduation from college.Is this something to be worried about? [/INST] Doctor:hi.and welcome to hCM.AST and/or ALT values higher than twice the upper limit of normal should be properly investigated.Esp test for HBV and HCV.secondly, obesity , alcohol may also lead to liver injury.hope to answer your concernregardsDr Tayyab Malik </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest cause and remedy for severe pain in lower back Patient:hello! I have been on my menstrual for little over two months (on bc) have had ultra sound, I have severe pain right lower back side with tennis size balls blood clots I am having accidents in my clothes what else can be done please help and all blood work is normal [/INST] Doctor:Hi, thank you for posting.I have gone through your query and I understand your concerns.Based on your symptoms I can say that you suffer from endometriosis. Another possibility is that you suffer from hormonal disorders.To treat this condition you should use antibiotic medications, progesterone and non steroidal anti inflammatory medications.An antibiogram is necessary in order to determine which is the right antibiotic for your case.Contact your gynecologist to discuss about the diagnosis and treatment.Wish you good health.Dr. Behar. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes the condition of gall bladder collapsing? Patient:my father is 65 years old, he had diagnosed with renal calculus measuring 23mm, he undergone for PSWL (Lithotripsy), we scanned after 1 week the stone halved into two pieces measuring 7mm and 16mm. scanning report say that his gall bladder is collapsed.help me in treating condition as he is heart failure patient having 30% EF [/INST] Doctor:1) gall bladder collapse generally after intake of food as bile is released from gall bladder to duodenum.2) gall bladder is evaluated in fasting state as it is distended which provides better evaluation in CT scan or USG abdomen </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Diagnosed with arachnoid cyst, brain aneurysm. Experiencing chest, abdominal pains. Related to brain issues? Patient:I m a 38year old female. I have been diagnosed with an arachnoid cyst on the left temporal lobe followed with a diagnosis of a brain aneurysm in the left venous cavity. I ve been experiencing a lot of chest pain and abdominal pain . The chest pain feels like electricity, pins...the pain last less than a minute...I went to the ER, and an EKG , stress test came back normal. Blood work suggested that I may have a blood cle in my lungs but further testing revealed no clots. I was released from the hospital with atypical chest pain and told to take an acid reducer, also that I m borderline anemic. I m still having the same pain. I asked the cardiologist if it could have something to do with my brain and her response, I don t think so. Could this pain have something to do with my brain? I do have Asthma. And an ultrasound was done but not sure of the results. [/INST] Doctor:Arachnoid cyst and brain aneurysms will cause headaches. not chest or abdominal pain. there is no relation </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Stomach pains with diarrhea. Had gallbladder removed which was 80 % full of stone Patient:I m a 21 year old female I m 5 5 and about 150 and the last few days I ve had abdominal pain been told its from acid reflex and also sometimes its tender to touch left and right hip bone and I ve had diarrhea all day can someone help I ve had stomach problems for almost 3 years about a year and a half ago I got my gull bladder removed from being almost 80% full of stones stomach pains stopped for a while after that then started up again my doctor just keeps telling me its acid reflex but I m not sure sometimes I go a few days without pain then it starts again then also on my left bottom rib cage there s a knot like thing on it but my doctor said its normal that some rib cages change over time but it hurts and sometimes is sore to touch can someone help or are these doctors right and its all just in my head [/INST] Doctor:Hi,thanks for query.Acid reflux can not lead to pain on hip bones.Frequent abdominal pain along with off and on diarrhea,raises the possibility of Irritable bowel syndrome.This has got relation with anxiety also.Means when ever you are anxious the problem increases.Take light diet,plan your diet,try some stress relieving technique like meditation etc.Avoid stress if you can.Continue with the drugs given to you and you will be fine,bye. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: How to treat severe pain in abdominal area and under rib cage? Patient:my 11 year old son woke up last night screaming in pain clutching his abdominal area. He described the pain as a sharp/ripping pain when moving or taking deep breaths. This morning he seems to be feeling better although the pain persists. The pain is isolated now only to the upper right side under the lower ribcage. Should I be worried? [/INST] Doctor:Hi,If there is no other associated symptoms like fever, cough or breathing difficulty, we need not worry now. Just give him simple analgesics like paracetamol 2-3 times a day for 2 days. If the pain persists, or the above said symptoms appear, kindly take him to doctor for further evaluation.Take care. 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 causes pain in the upper cheek bone? Patient:hello i have been experience pain in my left upper cheek bone aswell as above my rear causing migrains and dizziness this has never happend to be before and has been going on for about 3 weeks consistantly curious if you have any suggestions? sex:male height:5.10 weight:190lbs age:25 [/INST] Doctor:Hi, As a first line management you can take analgesics like Paracetamol or Aceclofenac for pain relief. If symptoms persist, it is better to consult a physician and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What is the use and intake method of susten tablets ? How does it help ? Patient:hi, I am 33 years(female), 50kg,my doc advised to take susten 100 as its my 25th day, i want to know how to use suten100, can i have sex while using it [/INST] Doctor:hi u should use it once daily or twice a day. u can sex while using it mainly it is use for safe pregnancy ask ur doc why he has given it. its progesterone tab. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes pressure on the upper abdomen with breathing problem? Patient:Hi, I am a 48 yr old woman. (145 lbs) Since Sept./11, I have been feeling upper abdominal pressure and some breathlessness. I've had many tests done to determine what the cause may be. Last week I had an ultrasound done which determined a 4.6 cm cyst on the left ovary. The result also read "There is a complex left ovarian cyst not present in 2009. Some of the septations are thick, irregular and demonstrate vascularity. Gynecology consultation is recommended, as an ovarian neoplasm cannot be excluded". My doctor sent me for the CA125 test and she called and said it came back very good. She is referring me to the gynocologist. I am probably reading too much on the internet, but I am really concerned. This anxiety and stress is certainly not helping the stomach pressure. Can you help shed some light on my situation? [/INST] Doctor:You need CT scan to confirm further and the situation nearby the cyst. By rule the complex Ovarian cyst should be removed and sent for Histo-pathological examination. Upper abdominal pressure and breathlessness may be due to some other problem. This needs to be investigated by X-ray Chest, if there are findings you have to undergo the CT scan of the chest too. Cancer has to be ruled out </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What does bumps on penis after having unprotected sex indicate? Patient:hey Dr.Samuel im 10 y\o and i have a question, i barely notice them today but, i have these two bumps right next to each other on my penis im assuming that there are ingrown hairs and hopefully not a std. ive also had sex two night in a row with two different girls and both times unprotected. so i was wondering if you can help calm my nerves by let me know what you think. [/INST] Doctor:Thanks for asking in healthcaremagic forum May be a boil as you think, but STDs cannot be rules out without examination. Please visit your doctor for the same. All the best. Till then be cool. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest remedy for swelling lumps in cheek Patient:Well this started about 2 to 3 days ago and I hve developed a swollen cheek and its just getting worst. It started out as a small lump on my right cheek and now the swelling has spread to the entire right side of my face. I thought it was just a bug bite. I have swelling and redness on my right cheek and numbness and a little pain near my jaw line. [/INST] Doctor:Hi,From history it seems that you might be having some poisonous bite on cheek giving rise allergic reaction on the part.Take antihistamine medicine like Cetrizine or Benadryl for2-3 days.If redness, swelling and soreness increases, go for one antibiotic medicine course for 3 days.Ok and take care. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: How does a pain clinic manage a cervical ruptured disc without drugs? Patient:I was just diagnosed with two ruptured discs in my upper neck. I have been scheduled to go to a pain clinic in two weeks. I saw my MRI and it scared me.Though the neurologist that I saw on Friday, didn t tell me much.Could you please tell me what I might expect from the pain clinic besides drugs.I am not excited about the thought of being hooked on drugs and then going to a rehab center as well. [/INST] Doctor:Hello, Consult a physician and get evaluated. An MRI scan is required for further assessment. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What does an enlarged liver and gall bladder showing adenomyomatosis mean in simple language? Patient:My liver is slightly enlarged(16.4) , margins are smooth and parenychymal echoes are coarse and enhanced (generalised . No focal abnormal echoes seen . Vascular pattern is normal . Intrahetic biliary ductules are normal , non dilated. GALL BLADDER - Few echogenic foci with posterior of artifacts seen in fundal region likely suggest adenomymatosis......what does all these reports mean in a simple language ?? [/INST] Doctor:HelloYour findings suggests mildly enlarged fatty liver with coarse echo texture.Coarse echo texture may indicate liver parenchymal disease.You may need clinical correlation and few investigations like routine hemogram,random blood sugar,liver function test,renal function test,lipid profile,urine RE/ME.Ultrasound findings also suggests adenomyomatosis of gall bladder.It is a benign condition characterized by hyperplastic overgrowth of mucosa of gall bladder,thickening of the muscular wall and formation of diverticulum or intramural sinus tracts(Rokitansky-Aschoff sinuses).Echogenic foci with posterior of artifacts seen in fundal region may be due to deposition of cholesterol in gall bladder wall.It may be an incidental asymptomatic finding and may not require any treatment.Get well soon.Take CareDr.Indu Bhushan </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes the tongue to get dry? Patient:my age is 25 years, my hight is 6 feet. my weight is 70 KG i have used all sorts ellopathic medicin but my glands do not produce saliva properly. my toungue is dried when i get up in the morning.?for last 5 years my toungue gets dried when i speak for 3 minuts after that i cannot pronounce the words properly. advocate hassan. [/INST] Doctor:helloo hasan...read through ur query...based on ur symptoms i can say that it can be a condition called xerostomi(lack or reduced saliva)..it can be due to many reasons..stress and tension or due to damage of salivary gland etc etc...but nothing to worry..u have to keep ur mouth hydrated then u can speak properly...drink lots of water...take chewing gums..certain drugs called sialogogues are also available...better take it aftr consulting ur near dentist...reduce tension...be happy..happiness is the best medicine for any disease...hope ur benefitted something by my reply..have a healthy day!! </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Kidney test reveals bilateral renal calculi and small vesical calculus. Is it normal? Patient:SirKidneys both are normal in size ane echotexture.Rt kidney 10.6X5.4cms. 4mm calculus noted in middle calyx, no hydronephrosis.Lt kidney 10.3X5.5cms. Same to rt kindey.Bladder 5mm calculus noted .Impression;- BILAYERAL SMALL RENAL CALCULI.SMALL VESICAL CALCULUS. [/INST] Doctor:Hipresence of stone in kidney and bladder can not be normsl and that answers your queryBladder stone may pasd out without interventionThe other stone may require surgical intervention bTake care Dr Lal Psychiatrist </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What cause chest discomfort? Patient:My boyfriend is 49, has high hbp. He says he feels a slight tighten in his chest and he's tired. We took his blood pressure and it's 112/72. He weighes 176 and is about 5'4 and is in good physical health...muscular type person. Should we be concerned about a heart attack? [/INST] Doctor:Thanks for your question on Health Care Magic. I can understand your concern. In view of history of hypertension his symptoms can not be neglected. Ideally ecg and 2d echo should be done in his case. If both are normal than no need to worry for heart diseases. Don't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest treatment for chesty cough Patient:I have had a chesty cough now for 3 weeks. After the first week and feeling poorly I went to the doctors and he gave me antibiotics, I felt a lot better straight away but the cough has lasted. I have been coughing up phlem. Its seems to be all on one side the side I had radiotherapy on 4 years ago after having breast cancer. I have been taking a cough bottle from the chemist but the cough doesnt seem to be going. [/INST] Doctor:HI, thanks for using healthcare magicChesty coughing usually implies that there is bronchitis which is inflammation of the bronchi. It can be viral or bacterial.The cough can last up to 6 weeks in some persons. You may want to consider the use of a mucolytic which would help to break up the mucus so that can be more easily expelled.In addition, short term use of a medication to open the airways may be needed.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 are the suggested treatments for lower back and knee muscle pain? Patient:Hi... need some advise on lower back pain, it is actually on the right side on the lower back just above hips. Also my left knee muscle (the one which can be felt under knee when sitting on chair) pains badly if i am sitting in chair or on ground or after driving for more than couple of hours. Please respond on YYYY@YYYY [/INST] Doctor:Hi,You are having low back pain which can be due to a disc prolapse or any degenerative changes of your spine the most possible reason is less of exercise and doing lot of static position like long time sitting. Due to Disc prolapse your nerve is getting compressed and there is this radiating pain that you feel on your calf muscles. You can take hot packs to relieve your back pain. Start activities like walking, swimming, avoid bending moments also can use a back pillow while driving if you need to sit for longer duration take a break after every half an hour. Hope this helps with your back pain and solved your query. Let me know if I can assist you further. Regards,Dr. Jenis Bhalavat </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What are the normal readings after TMT? Patient:hi ther sir, i have positive tmt no angina recorded do i need to do angiography and if yes i check my bloodtest i got esr 95 in two hrs and have 9cells in urine and 5 pus cells and s creatinine is 1.22 which was .93 week before does it make differnce [/INST] Doctor:If stress test positive need to go under angiography .. If recently raised esr need to evaluate for same first ... after this you can go for angiography.... As no emergency for angiography your creatinine is normal no problem for that.. if you have any fever or any other medical co morbidity </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Suggest any medication to avoid full blown cold and cough in kids Patient:My toddler is going to nursery and often picks up cold and flu bugs. She is again seeming to come down with a cold but I want to nip it before it becomes a full blown cold. Is there some medicine I could give my toddler to avoid setting of a full blown cold and cough. The throat bit I was able to eliminate with a combination of natural remedy - ginger juice honey and lemon and prospan syrup. Is there anything I could do for the cold. [/INST] Doctor:Hi...Thank you for consulting in Health Care magic.Cough and cold are viral 95% of the times in children. For cold you can use anti-allergics like cetirizine and for nose block, saline nasal decongestants will do. Paracetamol can be given in the dose of 15mg/kg/dose every 4-6th hourly, that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol.For cold you can use Cetrizine at 0.25mg/kg/dose every 12 hourly for 3 days.For nasal block, plain saline nasal drops will do, every 4-6th hourly to relive nasal congestion.Hope my answer was helpful for you. I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed)., </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Severe swelling in face. No relief from zyrtek. Help Patient:Hello,I have been suffering with swollen face for about a year now,just last afternoon while at work my face blew up like a ballpark frank,there's no pain just intense swelling of my jaws,lips nose,my allergist is not really sure but has a feeling that it may be angelodema,I've been taking allegry and zyrtek but I still swell up like crazy,can you shed some light on this for me,thank youWindell [/INST] Doctor:Hi, you had a swollen face since 1 year, have swelling of jaws, lips, and nose. Your allergist feeling it is angiooedema, it must be an allergy, and you have it since long, it is not secondary to some thing.Still there is a possibility of acute anemia, which can cause anemia. Lastly cause could be renal. I usually prescribe some mild steroid, and the antihistamine you have not used before like fexo fanidine. Thank you. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What could be the reasons for having lower stomach pain, lower back pain and acidity after having food? Patient:I have lower stomach pain, now accompanied by lower back pain. I've had symptoms for a couple of months, but usually just after I eat-and I feel super full of gas. Now it seems to be more frequent-and the pain is worse. I've had a CT and they said they didn't see anything...but this pain is BAD. [/INST] Doctor:Hi. CT scan has no power to see and diagnose everything , although this is the best investigation for abdominal pain. You have a classical complaint lower stomach and back pain after food with acidity. This can be caused by colitis( inflammation of large bowel) the pain increases as a reflex from a full stomach. I would advise a stool test, colonoscopy may be enteroclysis. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes swollen lips with a gum growth? Patient:Hi, I have 5 years old girl who suddenly got her top front lip swollen 2 weeks ago, after about 3 days the swollen go away, I found out there is a growth on her top front gum. The colour of the growth is red and a has a few white spot on it. I am really worry about it....I have search on the web, I could not find the right gum disease that similar to that one... [/INST] Doctor:Thanks for using Health care Magic.Read your query.In your query you have not mentioned if any of your child's in that area are decayed or does she has any history of pain/trauma in that region.By the complaint described, it can be a abscess related to any of the tooth which will require an thorough examination by the dentist .She may also require a dose of antibiotics .I would advice you to visit a pedodontist and get it checked as soon as possible and get the needed treatment done.Hope this was helpful.Thanks and regards. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Could elevated ALT and ALP levels lead to lethargy and weight gain? Patient:Hi my ALT and ALP have been elevated for several months, highest about 278, both currently at 143. I don t drink or smoke, but do over eat, very much a chocoholic, loving carbohydrates / sugary stuff. I have some fat in my liver and a 4mm gallbladder polyup. I m male 34 bout 5ft 8in height, bout 15 nearly 16 stone; so certainly overweight. Symptoms of severe lethargy have reduced as the serum levels have fallen, which may be drug related; reduced duloxetine down from 120mg per day to 90mg. Curious as to what the cause of the persistently elevated but reducing serum levels is. Can you shed some light? Thanks :) [/INST] Doctor:Dear FriendI understy your concern.I am more worried about your raised liver enzymes.They should be evaluated.I advise you to get following investigation:1. HBsAg2. Anti HCV Antibody.3. Complete LFT.If no cause is found on these investigation s we will do workup for Non Alcoholic Fatty Liver Disease.Don't take the things lightly.There is definitely some problem.Stay Healthy. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: What causes low white blood cell count? Patient:HI,I had my blood tests 3 days ago and i had some changes in my white blood cells:-white blood cells: 3.5 (normal:4-10)-RDW :16.8( normal 12-16)-white blood cells:3.5 (normal:4-10)neutrophile: 1.3( normal: 2-7)-basophils: 0.11 (normal:0-0.1)All other blood tests were ok. My haemoglobin was fine but i had a little bit lower iron level.I had had an E coli infection and i had taken antibiotics 10 days earlier my blood test. Also during 2011 i had 4 times urinary infection and i had problems with Candida caused by so many antibiotics.One day before my blood test i had taken a pill of Fluconazole for treating Candida.I am 27 years old, i have 51.5 kilos and 175cm. I always have been a skinny girl. I do fitness 3 times/week and i usually eat: 300grams of yogurt with 200 g fruits at breakfast, turkey breast or fish( 200g) with vegetables and a slice of rye bread at lunch, after 2 hours 400 g of cherries and at dinner i eat omelette (one egg and 3 whites egg), cottage cheese and cucumber.Do i eat to less?WHY do you think i have all these changes in my blood tests?Do you think i have tuberculosis or leukaemia? Are these lower white blood cells a big and dangerous problem? [/INST] Doctor:Hi, dear. I have gone through your question. I can understand your concern. You may have viral infection or some bone marrow problem. Leukemia is unlikely. Don't worry for leukemia. Just repeat your wbc count after a month. If it is persistently low then go for bone marrow examination. Consult your doctor and plan accordingly. And you should eat less to remain healthy. 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: Q. Are polycythemia and hemochromatosis related to each other? Patient:Hello doctor, Is there an association between polycythemia and hemochromatosis? I have a high Hb of 18 and hematocrit of 51 %. I am a student and found to have incidental polycythemia. I tested for all myeloproliferative neoplasm and bone marrow biopsy is negative for MPN. However, I was tested to have hemochromatosis type 4, an autosomal dominant disease for which I am heterozygous. But my HCT and Hb are always high at 18.2. Please advise me. [/INST] Doctor:Hello. Usually, in hemochromatosis, storage iron is increased, that is serum ferritin. So you can investigate with serum ferritin as well. If you have myeloproliferative neoplasm like polycythemia, then usually it can be clear from bone marrow study and JAK2 mutation. It comes under primary polycythemia case. You can rule out the secondary cause for polycythemia like lung disease, cardiac problem, high altitude, smoking, etc. Both conditions are different. </s>

<s>[INST]<<SYS>>You are a Bot identify the response from Patient and give medication as a Doctor <</SYS>> Description: Is it advisable to take Vitamin D injections in a grade II breast cancer patient? Patient:Hi, My mom had grade II breast cancer and every thing is completed including chemo and radiotherapy. Now she is having vitamin D deficiency. Doctor is recommending vit D injections. Is it okay to take those injections because i heard injections are painful and have side effects apart from its cost. Thank you [/INST] Doctor:Hi, dearI have gone through your question. I can understand your concern. She had breast cancer. She completed the treatment. But if she has vitamin D deficiency then she should take vitamin D supplements. Because low level can leads to weakned bone. So go for vitamin D level once and then 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>