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<s>[INST] Hi, may I answer your health queries right now ? Please type your query here... hi, my daughter is 4 yrs old, she has what the dr says as cyclical vomiting since age one yrs old. however, her conditions is worsening as she gets older with frequency of vomiting every 10-14 days and the vomiting is around 5-7days. she is admitted to hospital on each atttack. All the investiggation done was normal expect for mri brain which shows narrowing of corpus collusum and ceerebral atrophy. I dont know whaat to do. It is very traumatic for her to be poked 5-7 times each admission for IV line and regular blood monitoring [/INST] Hello, Yes, no doubt it's a troublesome condition, Some babies have cyclic vomiting without any abnormal reason. A big challenge for parents it will get settled by itself by the age of five until then goes with the flow. Check out if she is allergic to any food or anything that stimulate and starts vomiting. And stop it immediately syrup Dome three times a day will reduce the episodes during attack give ORS as much as you can during this. So that intravenous HY Chat Doctor. Syrup zinc ate itself for ten days will help to overcome. Hope I have answered your query. Let me know if I can assist you further. </s>

<s>[INST] So to make this short and quick Im a 33 year old male who has been disabled by a loosely or undiagnosed condition, as I see it, including symptoms ranging from chronic neck pain, eye pain, muscle spasms, body wide muscle tension, neurologic abnormalities, cervical radiculopathy, fatigue, pain in lower back/coccyx, low testosterone, low vitamin D, osteophytes mainly in my cervical spine/lumbar spine, mild stenosis in cervical, many different blood work abnormalities(IGG IBB.... antibody, ACE high, low RBC, high rheum factor, etc. Ive been seeing my pain management dr. for about 1 1/2 years+ who is a nurse practitioner. She seems to know less about pain management than I have accumulated throughout my 3 years of debilitating pain, and treats me like Im a statistic. Ive never violated my pain contract in anyway and have passed all of my drug tests. Ive also given her permission to talk to my family, friends, girlfriend, doctors. Anyways, my question is when is it time to seek the care of a new pain doctor. Ive gotten every procedure that theyve suggested, continue to see a slew of dr.s trying to get a confirmed dx so that I can work at the core of the problem and not just the symptoms. I realize I forgot to mention my problem with her care. She has me on 75mcg fentanyl patch, which has been the only long acting medication that even keeps me moderately functional though she refuses to prescribe a short acting med for breakthrough pain. Shes been putting me on a wild goose chase where she tells me to do something like see a pain psychologist then tells me not to, then told me to see him again last week. I feel that my pain is the primary symptom that is keeping me from finishing my bachelors and being a more functional person. I dont want to be on opiates all my life but I believe that keeping me as functional as possible until I find out what is causing all of this is a lot better than not. Ive tried physical therapy, yoga, meditation, ice packs, heat, hot baths w/ magnesium, distraction, etc. and nothing else seems to help. My PCP, psychiatrist, and family all believe its a logical idea but she does not. There is a Dr. in charge of the pain center and the last ditch effort is to ask him to intervene but Im afraid of getting nowhere and if I have to find a new Dr. I know that many are reluctant to take on patients whove seen pain doctors in the past. I hope you may help steer me in the right direction. Thanks in advance. Sincerely,Matthew Olsen [/INST] Hi Dear Mathew welcome to ChatDoctoryour concern regarding your health is normal, and you have got degenerative changes in your bones very early due to inflammation of joints and synovial membrane, I will advise you to visit again your orthopedic Doctor and ask him for further investigation like CRP, ANA, and HLAB27there are some immunomodulator which can retard the progress of ailment and some time reverse it, for pain management you can try Chat Doctor. </s>

<s>[INST] My 45 yr okd daughter has had zeiures all of her life. At this stage they are very infrequent but she does grind her teeth at night, even with a mouth guard. She is going to need several crowns put on her teeth, should we consider using the nitrous gas for this procedure? [/INST] Hello, Nitrous oxide is seen to cause a seizure in certain animal studies, but there is no controlled data for humans. However, in cases where it is used for conscious sedation, it is generally safe. I would, however, suggest you to first consult with her treating physician so that the levels of her anti-seizure Chat Doctor. Once consent is given, you can proceed accordingly. Hope I have answered your query. Let me know if I can assist you further. </s>

<s>[INST] hi everyone im john im 14 years old and i hurt my tailbone a few months ago. When i hurt it it didnt hurn when i sat down but it look popped out a little not a lot just a little. I love to wreslte and i was wondering what is my injury and how long will it take to heal thank you very much [/INST] Hi John... Your tailbone pain will be reduced in 2-3 weeks if you take proper care. I recommend you to. Do a lot of icing in your painful area. As frequently as possible...once in every 2 hours...for 15 mins.... Gentle massage over butt muscles... no massage over painful area... Gentle stretching if butt muscles...Dont the best weight over the painful area... U can use a Tyre like structure Tobit so that you Don't bear weight on the painful area... Can apply any Anti-inflammatory gel prescribed to you earlier.... Hope this is helpful for you... Kindly revert in case you need any more help in this regard.... </s>

<s>[INST] can I take your suggested treatments for congestive heart failure and hepatitis B together or should I do one for a few months and then start on the other. I would most likely start the treatment you suggest for congestive heart failure first. thanks for your time. Mary [/INST] Hello dear user! Thank you for sharing you concerns with us on Chat Doctor! Since you have been diagnosed with congestive heart failure and Hep B as well, you have to be in contact with your cardiologist and hepatologist continuously. They are conditions that must be taken under control any time, and treatments should be taken together. There is no reason to quit each of medication. The medication for the heart failure should be taken always, without stopping a day. It would be better if you consult your cardiologist to build up the proper scheme of your treatment because it will be a combined therapy and according to your cardiac function. ECG, and Cardiac ultrasound must be done to evaluate your heart function. Generally, As I said above, more than one Chat Doctor. - A beta blocker (metoprolol, carvedilol), to control the heart rate and increase cardiac output.- A diuretic (HY </s>

<s>[INST] bloodwork shows an elevated platelet count of 467 absolute reactive lymophcytes of 158 absolute eosinophils of 2212 absolute basophils of 316 been having stomach issues for a few months and dr wants to redo and manual review my bloodwork since it came back as abnormal, should I be concerned? [/INST] I would not be concerned about that platelet count. Depending upon the lab reference values, the level is most likely just minimally elevated and would not cause anything to be concerned about. Absolute white cell numbers are difficult to assess without the context of your total white count. Frequently, a minor cold or other viral infection can lead to a short-lived rise in platelets and different types of white blood cells. I agree with having your lab work redone, but I would not worry about the current numbers. </s>

<s>[INST] I am a 78-year-old female who broke my toe next to big toe when I was age 8 or so. It healed in a bent position like a hammertoe. Now I am having a difficult time with swollen ankles and inflammed fat pad on both of my feet. I weigh 138 lbs. and am 5 1 . I have this foot pain flare up several times a year. I usually ice and take ibuprofen and in three or four days it settles down, but now for the past few months my feet have been very sore and the other day were so painful, I could not step. I have been icing for the past few days and feel someone better but fat pad still red and looks swollen. Could you please give me an idea of what I am dealing with. Thank you so much. [/INST] Hi, thank you for providing the brief history of you. A thorough neuromuscular assessment is needed. As mentioned by you the brief history there are 3 possibilities coming in my mind for which a thorough neuromuscular assessment is needed. The first is a vascular insufficiency, the second is the increased uric acid levels and the third is the neuropathic pain.to rule out the factors here - performing a urine test will help us determine is the pain and swelling is because of the increased uric acid levels and by medication and physical therapy the pain and recurrence can be avoided. For ruling out the vascular insufficiency the Doppler test for both the Lowe limbs will be performed post which is the test is positive - rest, Medication and physical therapy will be advised for better results. You need to use even stockings of lower limbs to ensure the venous return. For the neuropathic pain, your blood glucose levels and MRI of lumbar spine will be guided. Post which based on the possible positive test the treatment will be planned. As due to aging factor - there is even a possibility of lower cardiac output and slower venous return can lead to swelling of ankles. Understanding that the body needs mobility more at this age to allow the venous return to occur and improve the metabolism as well. After a thorough assessment the root cause can be found and post which the treatment will be planned to avoid the future recurrence. RegardsJay In Chat Doctor. </s>

<s>[INST] i was having pain in my stomach and i made an ultrasound nd the repart shows that my liver size is increased,my alkaline phosphate is increased to173,and hepatits report shows tht hepatis a and b are positiv,,,,,i smoke as well,,what should i do,,,,or wht should i eat. [/INST] Hi, HAV is usually a self limited disease. However, for HBV infection, proper management and follow up is required. Bag can not be completely eradicated in a patient suffering from Herb. However, complications maybe prevented if proper medication is taken and proper diet plan is followed. Treatment is advised IF high values of liver enzymes AND high viral Load on a PCR. If HBV DNA count in PCR are not high, further advise:- abstinence from "Alcohol" - LOW fat diet should be followed, avoid junk food and beverages-decreased oil consumption (oily food)- NO red meat-green vegetables should be ingested daily-use lemon juice (lemonade) once in a day-reduce weight if overweight/observer enzymes should be monitored regularly while Herb markers maybe checked every 6 to 12 months. Hope I answered your concern. Let me know if I can assist you further. Wish you good sound health. </s>

<s>[INST] Hi, may I answer your health queries right now ? Please type your query here...Sir my wife aged about 28 years alwaya complaining about her chest pain. Most of the time when she get angry or get shocking news she feel pain in her chest & also having breathing problem. Kindly advice [/INST] Hi welcome to the Chat Doctor Here chest pain and breathlessness seems to be either from stress induced panic attack or by cardiac cause Work up done as follows... -Auscultation-Blood pressure measurement -EKG -Tread mill -echocardiography if needed -anxiety history According to cause further specific treatment given Hence with keeping all this in mind consult her to pulmonologist or cardiologist for examination Take care Hope your concern solved </s>

<s>[INST] Hi Dr, Our first baby boy born on 10th May 2014. He born on 36 week having weight 1.9kg. He is doing good but his doctor recognized an extra sound in his heart on 17th May 2014. According to his suggestion, we have showed to a pediatrician who is in service a branch of Narayana Health Care yesterday. He did some scan and told the baby has a medium hole (probably ASD, not sure still from his prescription) in his heart causing the murmur. He told that, this can be closed naturally till 2 years of kids age. He asked us to visit after 2 months. And take care of baby from cold and some precautions. He has given a syrup named some furosemide(not correct) to have 1 dose twice daily. My baby s is having mother milk nicely and gaining proper wait (2.3 kgs now, 27th May). Can you please let me know the in detail about the cure for this? And if possible what is the amount for 1 dose(1ml or ?) for the syrup furosemide(not correct)? Thanks, Probir Paul [/INST] Hi, After going through your babies case I want to clear certain facts about ASD (Atrial septal defect - opening in the heart wall which separate two upper chambers of heart, right and left atria). Every child is born with an opening between the upper heart chambers. It's a normal fetal opening that allows blood to flow away from the lungs before birth. After birth, the opening is no longer needed and usually closes or becomes very small within several weeks or months. Sometimes the opening is larger than normal and doesn't close after birth. Chil Chat Doctor. If the opening is small, it won't cause symptoms. If the opening is large, the only abnormal finding may be a murmur (noise heard with a stethoscope) and other abnormal heart sounds. In child </s>

<s>[INST] Hi Dr...I have a skin problem for the past 15 years and it is now ound as parapsoriasis. Both small and large lesions are there...I am really scared that this disease may lead to skin cancer...please suggest me treatment for this in ayurvedic and in allopathy [/INST] **1. Para psoriasis is considered to be a cutaneous lymphoproliferative disorder, and regarded as a malignant dermatitis with a substantial risk of progression to mitosis fungoides, a type of cutaneous T cell lymphoma [skin cancer], so consultation with dermatologist is required for examination [biopsy] and evaluation after which allopatry treatment can be initiated.PS. SUCCESSFUL TREATMENT OF PARAPSORIASIS EN PLAQUES WITH 2-4-DINITROCHLOROBENZENEEugene Man Chat Doctor. 1971;103(5):560-561. Doi:10.1001/archderm.1971.04000170094021.2. Take diet rich in protein, iron,folic acid, brown rice, orange, green vegetables, wheat, barley, green gram, lemon,turmeric, bitter gourd, garlic,pomegranate, nutmeg, bitter and sweet (not sour) food, </s>

<s>[INST] I have a hard lump deep in my back. It s located about 2 inches below my posterior rib cage and 4 inches to the left of my spine. It is very tender. It feels hard to me and is not moving. I keep reading it s likely a lipoma but this seems to present differently. I ve seen lipomas before and this is different. The lump is at least an inch in length. I am only 38 years old. The lump has been there for at least 6 months but hasn t been bothersome until now. I appreciate any input. I m nervous it s something bad. Thank you. Gina [/INST] Hi Gina ! Good evening. I am Chat Doctor answering your query. It seems to be a tense cyst feeling hard with secondary infection giving rise to the painful sensation. Even though the swelling did not bother you so long, I would advise you to get it operated (excision biopsy) and send it for histopathology test. If I were your doctor, I would first prescribe you with a broad spectrum antibiotic, an anti-inflammatory Chat Doctor. I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing Chat Doctor to clear doubts on your health problems. I wish you an early recovery. Chat Doctor. </s>

<s>[INST] My wife aged 30 years with two daughters. My 2nd daughters age is 9 months. After my 2nd daughters birthing, my wifes first period started on July 2nd, 2013 and closed regularly within 5 days. Today is 19th of August, 2013 and no period yet occur. Some times she felt pain in her lower abdomen. In the mean time I had two pregnancy tests and found negetive result. I had consulted with one of pharmecy person and advise me to let her take isovent 200mg tablet. He advise to take 2 tablets (200+200) orally and to use 2 tablets (200+200) at night and next day (2 tablets+2 tablets+2 tablets) orally. Please advise me what should I do?N.B. : Dear Sir, I am not in a position to pay for it.My name is UZZWAL KUMAR PAULe-mail : YYYY@YYYY , YYYY@YYYY [/INST] Hello, Thank you for the query. I have gone through your query and understood your concerns. The first thing I advise you not to take prescription Chat Doctor. And to tell about your condition it is quite normal to get irregular periods for some months after delivery. But if you think that you might be pregnant then you need to consult your doctor first for this as it is too early to get pregnant after a childbirth. If you were my patient I will definitely go for a hit and a scan to rule out pregnancy and then only accordingly I will prescribe the </s>

<s>[INST] Hello Sir, This is Vipul Sharma, from Jaipur. 10 Years ago I met with an accident. My right knee was injured but not factured. Now these days when i started jogging or morning walk, i feel alot of pain in my Knee & unable to walk aswell. Please advise. Thanks [/INST] Hello, It looks that at present you are having pain at your right knee. After ten yrs of good performance if there is pain at your knee then this is most probably not due to old injury. At present this pain can be due to:- Chcon Chat Doctor. Till then, you may have a good analgesic like paracetamol or diclofenac for relief from pain. You may also apply a knee cap to support your knee. Hope I have answered your question. Let me know if I can assist you further. </s>

<s>[INST] i have been experiencing extreme fatigue, severe back pain in my spin the best way to describe is it feels like I have splitters.I have severe foot pain especially in the morning it hurts to walk.I have gained a lot of weight over the last few months mainly in my stomach. I break out in rashes only on my neck like hives.I do not sleep well Im up at least 2 or 3 times a night.These symptoms have been going on off and on over the last year. The pain in my feet has become quite severe over the last month. [/INST] Hello, I have studied your case. Due to compression of this nerve root there is pain in your back and leg. I will advise you to do MRI spinor these symptoms analgesic and neurotrophic medication can be started. Till time, avoid lifting weights, Sit with support to back. You can consult physiotherapist for help. Physiotherapy like ultrasound and inferential therapy will give quick relief. I will advise checking your it B12 and it D3 level. Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take care </s>

<s>[INST] HI DR M FROM INDIA BANGLORE MY SKIN COLOUR IN BROWN NOT EVN SO DARK BUT MYREST OF BODY IS FAIR IAM 23 YRS I HAVE BEEN TRIED MELAGLOW , KOJIC ,BUT I DIDNT FIND ANY DIFFRENCE IN MY SKIN COLOR I DONT HAVE ANY ACNE PROBLEM R ANY DARK SPOTS OR ANY SUCH PROBLEMS CAN U GUIDE ME THE RITE CREAM SO DAT IT CAN GVE ME FLAWLESS FAIR SKIN [/INST] Hello, Welcome to Chat Doctor. Your skin tone is determined at the time of your birth itself, and it is decided by the concentration of melanocytes and circulation. Therefore, any treatment or procedures can never make you fairer than what you were at the time of birth. But most of the people will acquire more pigmentation as age increases, we call it facultative pigmentation. Lot of factors determine it, most important being sunlight, others include dust, pollution, smoking, less HY Chat Doctor. Treatments should be to bring your pigmented skin back to your normal skin tone and make the skin tone even all over the face. I would recommend you to use a face wash twice a day ideally a one containing glycolic acid as it helps in exfoliation and to even out the skin tone. The most important product will be a sunscreen. Half an hour before going out apply a sunscreen and reapply it every three to four hours. At night, you may apply a lightening cream containing comic acid over the face before going to sleep. You may consult a dermatologist practicing cosmetology for few sittings of chemical peels for faster improvement. Hope this helps. Take care. </s>

<s>[INST] My wisdom tooth has cavities and my dentist suggested that i have it extracted. But due to financial problems i havent been able to go back. Also my lower molar has gold filling and it has t hurt for more than 10 years. But now its starting to hurt. I was informed that gold filings last forever. Is the pain because of it or because of the wisdom tooth? Im also having headaches everyday. Is it because of the tooth or something else? [/INST] Hello, In my opinion you need a dental exam to determine the source of your discomfort. Decay will get larger with time and can cause an infection. The spread of an infection can make other teeth hurt. All fillings will wear and decay can get underneath. Pressure sensitivity can indicate a problematic tooth. Infected teeth can rise and cause a change in how you bite. This could give you a headache. </s>

<s>[INST] i Have recently been on a very strong aniboitic and take 6 25 gm of methadextrate a week, I wear upper dentures which fit propery. I noticed a sore spot on the gum and last night when I removed my denture there was blood in it... I do use a glue and always have. How can I heal it, I have been using salt water ever hour. [/INST] Hi, Welcome to Chat Doctor, You have not written which Antibiotics you have taken. Penicillin related antibiotics can interact with Methotrexate (Methadextrate), and increase the level of Methotrexate in blood. Increase level of Methotrexate can cause side effects like decrease in White blood cells, which can cause sores in mouth. Denture can irritate the sore and can bleed. You must go and see a Doctor. He or she would examine you and may you to do blood test tor WBC count. If it is low, you may have to skip Methotrexate this week. In the future, before taking any medication, you must inform your Doctor that you are on Methotrexate. Take care. </s>

<s>[INST] iam 25year old . after my 1st delivery i had a severe pain in back hipbone and my doctor advised to take tab microcid 25mg regularly ... daily in the night i was taken the tab almost three years .. now what i want to know is we plan for a second baby and what are precaution i have to follow . is there any problem if i continue the tab in the pregnancy period what are the side effects are happen ....myself and the baby . one of my friend told me is there severe problem could happen if i take the tab... give me the best suggestions so i will get an better idea ... [/INST] Hello, If you are planning for a baby again then the medicine you mentioned should be stopped. Since its painkillers, these are not good for the pregnancy. Rather taking medicine for pain during pregnancy stick to hot water fermentation and peripartum exercises. This will help to reduce pain and no trouble to the baby as well. Also, as you had back and hip pain I think you have muscle weakness and needs to work out behind it to get it strengthened. If you are planning for a baby do peripartum exercises and not for now. As any abdominal exercises will have negative effects over the baby for now. Wait till the pregnancy duration is over and do pre par tum exercises. Hope I have answered your query. Let me know if I can assist you further. Jay In Chat Doctor. </s>

<s>[INST] I have been diagnosed with congestive heart failure I have read that 200mg of thiamine will make my heart blood flow properly I now suffer with my heart beats very fast and my blood do not flow from one side to the other at a full capacity. tell me how correct this without meds. thanks Ms Hill [/INST] HiT hanks for posting your query. Well it is not possible to do that without medication. But you can try doing Yoga, if done properly over a period of few months your heart condition shall gradually improve. But Yoga has to be learned from a teacher and has to be started gradually. Reduce the intake of salt and non veg food. Eat daily carrots, beet roots and citrus fruits. Hope this information was useful to you. Any clarification feel free to ask. Regards. </s>

<s>[INST] Hi. I was recently diagonesed with Hepatitis A which resulted into Jaundice . My enzymes levels were significantly elevated and bilirubin was raised to 13. After several LFTs, now my enzyme level has come down but bilirubin still seems to be high. How much time does it normally takes for Bilirubin to come down to normal? [/INST] Hello, Gaurav.Khan, I am glad that you are recovering from acute hepatitis-A. Rest assured that you will completely recover from this without any residual damage to the liver. This does not go into a chronic phase like Type-B or Type-C hepatitis. Your enzymes have been coming down and so will the serum bilirubin. Usually, it takes about 4 weeks for all the lab results come back normal. I want you to make sure that you take a good Super B-Complex Vitamin along with Vital 1000 mg. daily. Follow a good high protein diet, cutting back on fatty and greasy foods. I wish you well. </s>

<s>[INST] Hi doctor, Sometimes a white colour liquid is coming from my penis with hard stools. I am facing this from last one month.may be I have not noticed before. I am not facing any pain or other disturbances at the time. Is it common or anything to worry??I am 28 years old, unmarried man and I never had sex. thanks Jithu [/INST] Degree understand your concerns went through your details. The white discharge you are talking about here is semen itself. Semen discharge through penis during bowel movement is quite common and there is nothing to worry about it. Your body produces semen whenever you are sexually aroused. Such produced semen will be stored inside your body, and it is a waste product. Body will try to clear it out of the body. If you do not masturbate or engage in sex, and eject the semen, body has to find alternative methods. Body uses nocturnal ejaculation method or fiction through urine method. These are natural process, and you do not have any control over it and therefore do not worry or be anxious about it. If you still need my assistance in this regard, please use this link. http://goo.gl/aYW2pR. Please remember to describe the whole problem with full detail. Hope this answers your query. Please feel free to post follow-up queries. Available for further clarifications. Good luck. Take care. </s>

<s>[INST] my dad passed yesterday, 16 days ago he survived open heart surgery which included a valve replacement quad bypass and aorta streghthening, he was released to a rehab facility and was doing well they took him to hospital for a chest x ray and blood work, he became unconsious and passed away from fluid in and aruond the lungs my question is could this have been prevented? [/INST] Hello derisory to listen about the loss of your dad, may his soul rest in peace. Warm welcome to Chat Doctor.come have evaluated your query thoroughly.* The fluid around lungs may have different issues - fluid overload - lung infection - septicemia - cardiac issue with secondary event - others.* So far as the prevention question is concerned, it requires in depth case study with series of evaluation, one of which require postmortem. Hope this clears your query. Regards. </s>

<s>[INST] Doctor, I have abdominal pains, neck pains and my diarrhea has lasted for almost 5 week now. I do have occasional pressure at the top of my head but I wouldnt consider it a migrane. I am often tired, short of breath and today a few chest pains. Is this hiv symptoms? [/INST] Hi long standing diarrhea is quite worrisome in your case would like further information likely history of weight loss cough or fever any history of unprotected serif it is yes then please visit your doctor for the diagnostic test shave plenty of dietary fiber and fresh fruits you can have probioticsplenty of fluids and juices daily exercise Hope this will be informative and useful too nourish you good health </s>

<s>[INST] So on my right breast my areola turned darker it itches it has patches like dry patches I went to a clinic and the Dr said it was milk but I ve had it over a year now it just itches real bad and it s super annoying I put hydrocortisone and seems to get a bit better but if I stop putting it , it start again the itchiness the dry scalpy patches what is it and how can I cure it ? [/INST] Hello, Thank you for posting on Chat Doctor. It seems you are suffering from Tina corporal, a kind of fungal infection. I would suggest you to consult your dermatologist for proper management of the condition. I usually recommend proper course of oral antifungal Chat Doctor. You can additionally use antifungal dusting powder containing ketoconazole during daytime and a soap containing ketoconazole for rinsing of affected areas. Take oral antihistamines for itching as required. Maintain hygiene over those areas and avoid wearing tight undergarments. Hope your queries are resolved and wish you best of health. Kindly spare some time to rate my answer and </s>

<s>[INST] My 16 mt old grandchild is exhibiting a fiery red rash on trunk and back of neck with some raised welt like lesions that are very transiet. He doesn t seem to be feeling very well - possibly a low grade fever. Question an allergy bur concerned because of West Nile season etc [/INST] Hello, I appreciate your concern. What you are describing seems to be a form of allergy, called urticaria lesions which are raised and welt-like. A viral infection (in view of the fever) is the most likely cause. Others could be an allergic reaction to a new food or piece of clothing/bedding (as it is confined only to the shirt area) The rash with West Nile virus will be smaller spots and bumps, which appear after the fever settles, so you need not be concerned. I would suggest an anti-histamine to help with the rash and itching, it is important that you measure the temperature and give paracetamol if temp crosses 100 F. Hope he feels better soon! </s>

<s>[INST] ..my daughter has had a diaper rash, a few boils she was given antibiotics but now her vulva is swollen and their is a hard bump under the skin on her vulva what should i do? [/INST] Hi, Was the boils also on the diaper area? When the antibiotic was completed? If painful, this can indicate infection/cellulitis there, necessitating another course of antibiotic. If no much pain/local redness/warmth, and no fever, just try paracetamol/ibuprofen three times a day after food for 3 days. If not getting down by then, or the above said features are present, kindly get back to doctor. Hope I have answered your query. Let me know if I can assist you further. Take care </s>

<s>[INST] I have taken an ChatDoctor pregnancy test only ONCE. And it appeared to have a positive result. (With two red lines, one dark red and one slightly faded). I want to make sure if this really is an accurate result. I haven t experienced puking but every morning. I tend to feel dizzy and sort of a feeling of disgust. Am I really pregnant? [/INST] HI, Thanks for the query. I understand your concern. Delayed periods with weak + ve pregnancy test (probably due to earlier testing)along with dizziness does suggest pregnancy. Still it needs to be confirmed. An uncontaminated urine sample (Collected in boiled bottle & without being polluted with vaginal/ urine infection). Gives confirmatory pregnancy test results after 8 days delay in normal periods. In case menses are irregular, Blood Chat Doctor testing or USG of pelvis after 5 weeks is confirmatory of pregnancy. Thanks. </s>

<s>[INST] Dear Doc.I am having the irritations and itching in my whole body skin including head.itching starts after a red colour appear in the skin and some type of inflammation also. Is it the desease of Psoriasis? I consulted a Doctor in Calicut and he advised me the following medicine;-1- Tab. Nurobion forte 1 tab 3 times/day2-another paste prepared at hospital Acid sil 5 gm,Naseline 100gm , HAD 5gm These medicine I am using for one month but any improvement is not visible and I am suffering the itching severly. Doc, Shall I get any advise in this subject/? Chandra Mohan [/INST] Hi, Chan Chat Doctor. . You suffer from generalized pruritic. You have star itching and burning. There may be redness. You have not mentioned for skin lesions. So, do not worry, you do not seem to have psoriasis. The disease may be either irritant or allergic contact dermatitis. You consult dermatologist for firm diagnosis. Blood tests may be done to rule out DM, HIV,anemia, other blood or internal disease. Avoid suspected irritants or allergens like soap, dust,house dust mite, woollen clothes, grass particles, fume,deodorants, cosmetics.you may take antihistamines like levocetirizine to relieve itching. Steroids may be taken in tampering doses. Apply mild steroid cream on affected areas. I hope you may be alright in few weeks. Thanks. </s>

<s>[INST] Hi, I have 1 yr old baby girl, been giving Calcium supplements (Calcarea Phos.) to her. Recently doc advised to give Iron also as she is Anaemic. Yesterday she had loose motions, doc advised to give Zinc suspension for 2 weeks . Please advice can i give Calcium, Iron and Zinc all together. or should i stop giving Iron till Zinc suspension is over. [/INST] Hello, You can give those vitamins all together. In fact, trying to increase those in her food would be best. Is she not Chat Doctor? Also, if she needs calcium she probably also needs vitamin D. Milk is the easiest solution to that (or yogurt, ice cream, cheese). Will she take mushed up prunes for iron? Lentils and nuts are good for zinc (if she doesn't have allergies). Sometimes It's so hard to get a 1-year-old to eat a variety of healthy foods, isn't it? Hope I have answered your question. Let me know if I can assist you further. </s>

<s>[INST] My Mother is 85 years old and my Father told me this morning when she went to the bathroom she her stool was black, dark. She is a two-time breast cancer survivor and it being evaluated for dementia. Should I try to get her in tomorrow (Monday) to her primary care or wait to see if it continues to be black. She lives in an Assisted Living Facility, should I have them notify the Head Nurse at the Facility first? [/INST] Hello, Yes, please notify the head nurse about the black stools. Black stools usually refer to bleeding in the intestinal tract, cause of which needs to be evaluated. Most importantly she requires a clinical evaluation by a physician and look out for anemia and get a complete blood count done. If He is less than 7 then she may require a blood transfusion. However, to be certain, a physician must examine her and take a call regarding further management. This issue may not be related to her cancer history, however, she should be evaluated in detail to get to the bottom of this black stools. Hope I have answered your query. Let me know if I can assist you further. Take care Chat Doctor. </s>

<s>[INST] why do i seem to have pains in my chest region that can take my breath away. also when i eat salty food i get chest pains. i have had very painful feelings in the area where i know my heart to be in the central area of my chest slightly to the left, when this occurs it is hard to breath due to the pain cause when my chest cavity expands. i fear heart problems, i have experienced a cracking or popping sound form this area when i struggle through the pain to take a breath. this has maybe only occurred 10 or so times since i can remember.. any advice. [/INST] Thanks for your question on Chat Doctor. I can understand your concern. In my opinion, you are mostly having HERD (gastroesophageal reflux disease) related symptoms because your symptoms worsen after eating. But better to rule out heart diseases first because you are having left sided chest pain. So get done ECG and 2d echo. If both are normal then no need to worry about heart diseases. HERD is more likely in your case. It is due to laxity of gastroesophageal sphincter. Because of this the acid of the stomach tends to come up in the esophagus and cause chest pain. So avoid stress and tension. Avoid hot and spicy food. Avoid large meals, instead take frequent small meals. Start proton pump inhibitors and prokinetic Chat Doctor. Quit smoking and alcohol if you have these habits. Don't worry, you will be alright. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. </s>

<s>[INST] i had unprotected sex on the21st 3days after my periods and had postinor2, on the24th ,,my ovulation is suppose to happen on the 26th,,,im worried that i could still be pregnant..is it possible to happen like that.if so how soon can i do a test..thank you [/INST] Hi, It is not impossible to get pregnant after taking Posit nor. The emergency contraceptive pill like Posit nor is up to 94% effective in preventing an unwanted pregnancy if it is taken within 72 hours following an unprotected sex. Its efficacy would be more if taken as early as possible following an unprotected sex. Pregnancy tests are done to tell if your urine or blood contains a hormone called human chorionic gonadotropin (Chat Doctor). This hormone is produced right after a fertilized egg attaches to the wall of a women uterus. Blood tests are more sensitive than urine tests and may detect pregnancy from about 6 to 8 days after ovulation. The home pregnancy test using an early morning urine sample can be undertaken about a week after missing a period. Hope these answer your query. Let me know if I can assist you further. Feedback is appreciated. </s>

<s>[INST] my gall bladder have been removed 3 years ago because of stones in it , i am 22 year old , i have problems in digestion of food , if a skip 1 meal in a day it leads to loose motions . For last 2 days i am feeling bloating in my stomach and today i am having pain in my chest in same place where my gall bladder have been removed also sour vomiting and its still paining [/INST] Hello, At first I would suggest you never to skip meals. With a history of cholecystectomy (gall bladder removal) 3 years back and suddenly having bloating and pain, you must get yourself evaluated for biliary obstruction possibly due to common bile duct stones, which needs to be ruled out firstly. Then other causes like infection need to be suspected. Please consult your surgeon and get blood test and ultrasound abdomen done. Hope this helps. </s>

<s>[INST] I am a 49 year old woman and my blood pressure is currently 119/90. I have been very weak today and while I do not have chest pain, it does feel a bit strange and I am short of breath. I came home from work today because I felt dizzy and dehydrated even though I have not had a loss of fluids. I have been nauseated, but I have not thrown up. Could this be a heart problem? [/INST] Hello, After going through your medical details I understand your concern and would like to tell you that your blood pressure seems fine, but your symptoms are not. Many reasons are there like medication, heat exhaustion, low blood sugars which can cause deny Chat Doctor. Kindly, get an ECG and Echocardiography done to exclude any underlying heart disease. Apart from that get CBC, Serum electrolytes and RBS and consult your primary health care provider for further management. Hope I have answered your query. Let me know if I can assist you further. </s>

<s>[INST] There is a pocket full of fluid inside my mouth that keeps growing in not sure what to do about it. It was an excruciating tooth ache for about 2 weeks but I used lots of mouth wash and was massaging my gums with the tooth brush and that subsided but now I have this pocket that feels weird [/INST] Hello, As you are mentioning that you were having toothache 2 weeks ago and after that you felt that there is some fluid filled swelling present there, it looks like that the tooth was infected and now the infection has spread to the apical region and there is some pus there which is causing this swelling. Only mouth wash can not solve the problem you have to visit a good dentist, as he will go for root canal treatment of that tooth and the problem will be relieved. Thank Regards </s>

<s>[INST] hi, i have been married for 6 yrs for now. n i m not able to conceive. once i conceived in 2009 but the baby could not survive for more than 15 days in my womb.then i m still on infertility medication. now recently i started blotting so got my TSH tested it was 5.4. i m taking medicine for that.i m due for today for my mensus. now my doubt is it difficult to concieve at this stagemy abdomen has also bloated as if i m carrying. i get my peroids regularly. plz reply [/INST] Hi, I think you should go for GUI. You can take some medicines like camphene for the growth of your follicles and track your follicles' growth by repeated ultrasound and when your follicles is more than 17 to 18 mm, take injection for rupturing the follicles. GUI will be done the next day. Take progesterone for next 2 weeks. Do a urine pregnancy test at home. You can try like that for 3 to 6 months. If it doesn't work then you can go for IVF. Discuss with your doctor regarding this. Hope I have answered your question. Regards </s>

<s>[INST] Hello so i was wondering i have the birth control implonon in my arm my doctor sed it was good for two years. I was wondering what could be the sighns of it whereing off? and if i were to keep it in and not get it taken out would it do anything? would it be bad to keep it in and get pregnent later on? one more thing so i got it in 2011 its 2014 and i never had a period on it but this last year i have been haveing periiods not light blood but dark and about a medium amount of blood is that a sighn its whereing out or is my body getting rid of old blood? pleas help me thanks [/INST] Hallow Dear, The life of the implant you are having in your arm is two years as your doctor has already informed you. You had put it in 2011. So its life has ended in 2013. It is not good to keep it in the body after it is no more active. When we say it is not active, we mean that the hormones released from the implant are not in sufficient quantity to prevent the pregnancy; however, it is not completely devoid of the hormones. The very fact that you have started having irregular bleeding, the implant is releasing the hormone erratically in low doses. You should get the implant removed and replace it with another one if you still want to continue with the contraception. With such extinct implant, you cannot plan your pregnancy appropriately either. I hope you got the message. </s>

<s>[INST] HI, MY ELDER SISTER IS SUFFERING FROM MANIC DISORDER, SHE WAS GIVEN MEDICINE SUCH AS LITHOSUN SR & SIZODON PLUS WHICH WAS STOPPED 1.5 YEARS AGO & AFTER THAT SHE BECAME THE AS EARLIER. 3YEARS BACK SHE WAS ADMITTED IN GURGOAN IN DR.NIKHIL RAHEJAS NURSING HOME FOR 30 DAYS. I KNOW STOPPING HER MEDICINES WAS A BLUNDER ON OUR PART BUT SHE HAS BECOME VIOLENT & THINKS THAT SHE IS SUPERMAN . I AM PLANNING TO SEND HER TO A PSYCHIATRIC CLINIC FOR TREATMENT USING PROFESSIONAL PEOPLE AS SHE IS VERY DIFFICULT TO MANAGE. KINDLY SUGGEST YOUR OPINION. [/INST] Hi. I understand your concern. Manic disorder is classified under bipolar disorder. It is episodic illness. Require proper treatment of 1st episode otherwise it has high relapse rate. If she was responding to lithium in past then it is advisable to give lithium again. Indoor psychiatric care is must. Treatment requires under supervision. Besides lithium medicines like sodium valproate/olanzapine/risperidone etc. will be useful If she is not manageable at home then admit her in psychiatry institutions or hospitals. Injectable medicines will useful to control her behavior in initial stage. Do ttake advise from your treating doctor or psychiatrist. Happy to help you further. Feel free to ask. Thank you. </s>

<s>[INST] I am having vitiligo disease in my body parts. I am 55 years old man had under gone operation for pitutiory macro adenoma during 2002 and taking madecins like Eletroxin 1.5 mg daily and wyslone 5 mg on altranate days. I want treatment for my vitiligo disease. [/INST] Hi, Vitiligo is an autoimmune and partly genetic skin disease. It is a harmless condition. Patient does not have any debility except cosmetic look. If you do not feel bad with this pigmentation, you may avoid treatment. If you want to take treatment, you consult dermatologist. He may examine you thoroughly, and then he might decide the strategy of treatment according to the severity of the disease. Trimethoxsalen, levamisole, bavchi.etc. may be given to you by your doctor in proper dose. Psoralenoint or lotion, decapeptidelotion, tacrolimus point or pimecrolimus cream...etc. may be applied on the patches. Recovery takes long duration, so you should keep patience. I hope you got my answer. Thanks. </s>

<s>[INST] My 8 month old has fever since 3days. She has difficulty in passing urine and also refuses to take any fluid other than my feed. When we visited her pediatrician we were asked to test her urine(urine routine). there were traces of albumin, appearance was cloudy and 2-4 pus cells. She was asked to give 3ml Oflomac-m syrup morning n evening for 5 days for infection. Along with that Aminol drops 1ml every 4-6hrs as per her temperature. Its the third day today and her fever is back after 7-8 hrs with temp varing from 98.5 - 100.4 F. Pediatrician asked to stop Aminol drops and start meftal p syrup 2.5ml 6-8 hrs. will this change cause any problem? which is better medicine for fever Aminol or Meftal p or any other drops? since birth we were using Aminol drops for fever. [/INST] HI... Paracetamol can be given in the dose of 15 mg/kg/dose (maximum ceiling dose of 500 mg) every 4-6th hourly that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol. Meftal-P contains Metonymic acid which is a NSAID. It carries the risk of gastritis and renal problems in the long run. Please do not use Metal. Hope my answer was helpful for you. I am happy to help any time. Further clarifications and consultations on Chat Doctor are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health. Regards - </s>

<s>[INST] hello....i have acute viral repetitious...and my ALT level was increased to 2500....now it has decreased to 200....i masturbated today....is this harmful to my health...if yes then how...??? also i want to ask is this acute disease transferred from one person to another by mouth to mouth kissing ?? [/INST] Degree understand your concerns went through your details. Masturbation consumes good amount of energy. In that sense, masturbation when you have some physical illness, is not advised. I wonder how you had the energy to do the masturbation when having acute viral infection. Many of the viral infections are contagious. I suggest you keep yourself in isolation. If you require more of my help in this aspect, please use this URL. http://goo.gl/aYW2pR. Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications. Good luck. Take care. </s>

<s>[INST] Hello Sir, Hope u r doing good. Sir, I am planning for baby since June13 but I am not getting result. I consulted doctor.She advised for fertile 50 mg tablet to take on 5th day of my period. but unfortunately I didnot get this tablet till my 6th day. can I take from 7th day onwards to get the result or I should try from next month?? [/INST] Hello dairy understand your concernFertile tablet will help to maintain fertility by inducing the ovulation. Clomid should be started on day 3 to 5 of your cycle and continue to take it at the same time every day for 5 days. You will likely be started on a low dose of Closed, such as 50 mg a day. This is to reduce the likelihood of developing cysts, side effects, and multiple pregnancies. If you miss the pill then take as early as possible. So I would suggest to start from the next cycle form day 3 or 5 for better effect. After taking pill must to sex on the ovulatory cycle to increase the chance of conceive. Avoid stress, take healthy diet, Chat Doctor. Hope this may help noncontact Chat Doctor for further health query Best regards </s>

<s>[INST] Hi. I have recently recovered from an eating disorder, that took place for 3 months, but I started recovering last month. My hair has started falling out in clumps, and it has gotten to the point where I am afraid to shower. It falls out when I don t even touch it, and has resulted in staying in a ponytail every day in fear of falling out more. Do you have any advice or vitamins or special shampoo that I should be using to prevent more hair loss, and help grow normally? Thanks! [/INST] Hi there.1. Your concern is halogen effluvium leading to hair loss.2. You can try reviles hair supplements daily one after breakfast.3. You can start using coliseum once daily bedtime, gently apply enough quantity into the roots.4. You can try anaphase shampoo weekly twice head bath with soft Chat Doctor. 5. prefer diet rich in proteins like egg white, sprouts etc. This will help you in protecting the remaining hair and hair growth, don't worry. </s>

<s>[INST] I have a very close female friend who is breaking things like the steel water tap of her house or something alse is this normal I don/t know why but she is breaking some strong things like steel staff or something like that when I think she get angry .when I ask her why she is doing such things in her house she replies I was angry and I must did it?Is it normal? [/INST] Hi Shake, Your question has too few details for me to even take a wild guess at answering. Could you tell if she has changed in any other way apart from breaking strong things? Does she have any problems in life now? Was she under influence of anything? Is it occurring constantly. Has she been always like this etc. etc. Aggression against property is considered a medium level of aggression higher than verbal aggression but lower than aggression against a person? But, it could be very justifiable aggression being just a one off episode, but if continues to occur, maybe she will need some help controlling her anger or channelling it constructively or at least in a less harmful way. Good Luck </s>

<s>[INST] My name is Dilawar Hussain my daughter Name is Madeeha.she is suffering for last 10 years from asthma so please advice me what should i do .I have referred many specialists in the field but effect of the treatment is temprory. Can you recommand any good doctor in my city .(karachi).Waiting for your reply.Thanks in advance. [/INST] Hello Delaware As you mentioned that your daughter is having ASTHMA, so first I want to tell you that don't be so desperate as this is very common in this Sub Continent and reason is allergy so call as asthmatic allergic bronchitis. Pollen, hay, fodder, fumes, smoking 9 active or passive), sudden rise and fall of temperature, mite, pests (cockroaches) pets (cats and dogs in house) are certain predisposing factors for this type of allergy. Bronchoconstriction is the main cause of such symptoms. Take these measure :Wash all bed covers in hot cycle every week. Treat carpets with parricides or tannin acid clean upholstered furniture keep dust accumulating objects in dustbins vacuum cleaner Encase mattresses, pillows & quilts in covers (impermeable) Install Air conditioner or dehumidifier. When such patient visit my clinic I only prescribe them to take MONTELUKAST+ALBUTEROL tablet once or twice in day and I assure you your daughter will be alright within 3-4 days. Stop the medicine, once symptom free, restart when some problems. In my opinion no need of any tension. Hot coffee and steam inhalation also provide instant relief. Good luck. </s>

<s>[INST] I have a PCOS and trying to conceive since 3 yrs. tried lot of infertility Medicine but all in vain. Also I have a thyroid problem. so now the doc. has suggested me to do ovarian drilling. Is it the right solution. Will I conceive??????? If yes after how many months.Please Help. [/INST] HIT hank for asking to ChatDoctorI really appreciate your concern, pregnancy is a more natural phenomenon and certain condition has to be fulfilled without this pregnancy would not possible, in my opinion the ovaries are not that munch matter than the, normal production ovum, normal semen, normal production of reproductive hormone, and last but not the least coitus in ovulation phase, if these are fulfilled then pregnancy for sure would be there, hope this information helps you, have good luck. </s>

<s>[INST] I noticed a mosquito like bite on my testicles on my right side, since I thought It was just a mosquito bite I left it alone, since the itching persisted, I cant handle it anymore. Just today I took a shower and I noticed that I have an identical bite on my left side my testicles , almost simetrical. I don t know if this is a concern or anything. [/INST] HelloThanks for query. What you suspect to be mosquito bite are likely to be small sebaceous cysts over scrotal sac, The scrotal skin is rich in sebaceous glands and hence prone to get more sebaceous cyst due to accumulation of sebum beneath the skin. Normally they fade away without treatment however they need to be treated if increase in size or get infected. Please consult qualified General Surgeon for clinical evaluation and further treatment. Ensure to observe proper personal hygiene. Chat Doctor. </s>

<s>[INST] I have a 44 yr old nephew with autism. He takes anti seizure medications and has for years. He does not talk, is quiet and has never caused any trouble. In the last week, he walked away from home, has been talkative and destructive. Why the sudden change. He went today for a brain scan and nothing was found. He also had a nuclear med. test but not results yet. [/INST] Hello, The patient most likely developed mood disorder during which it is common for them to move out, become aggressive, violent, demanding, difficult to control, and it seems that the person has changed completely by someone else. It is not uncommon presentation in patients with autism. However, there is no need to panic. You may take him to his psychiatrist and start the required antipsychotics. Chat Doctor. Till then please take care that he doesn't harm himself or others near him. Donor become violent or lose your temper on him as he is doing all this due to another psychiatric problem. Hope the reply is useful. </s>

<s>[INST] i recently had an abortion an i have been having pain in my lower abdomen , is painful to hold or press my lower abdomen mainly on the left hand side. it has also affected my left thigh it is painful too .i still feel nauseated and i didnt get any bleeding after the medical abortion.. laying on my tummy or on my left side is so uncomfortable and am scared of anything happening to my uterus and legs.it feels like I have sores in my uterus . advice me on what to do. [/INST] HelloThanks for the query to Chat Doctor. Forum. You didn't mention the way of medical abortion as it was with the help of pills or D & C. Still feeling of the pain may be due to .1 Retained part of some placenta or piece of it. Diagnosis can be confirmed by ultrasound of uterus or physical examination by a gynecologist. As you mentioned that pain is mainly on the left side & also in thigh, so chances of retained portion may be there.2 The next possibility may be some injury on the left side. As you are complaining that pain is on the left side, so may be some injury to uterus or other parts on the left side. Diagnosis can be confirmed by ultrasound and physical examination.3 As you mentioned that pain is so severe that it develop nausea i.e. So some sort of infection may be (septicemia). In my opinion consult a gynecologist and get his opinion. Good luck. </s>

<s>[INST] I am about 27 weeks pregnant with twins and have been having tightening and pain in my stomache for about an hour now. Some have been pretty bad but they are not really regular. If I get up and walk they get worse though. I am wondering if I should just go in or if its just braxton hicks. [/INST] Hallow Dear, You are carrying twin pregnancy. Twin pregnancy is prone for premature delivery due to overstretching of the uterus. However, 27 weeks gestation is too early for management of the premature child. The uterus is continuously contracting and relaxing throughout the pregnancy. You have very rightly mentioned them as Braxton Hicks contractions. However, Braxton Hicks contractions are never painful contractions. If you are getting pain also, they could be early labor contractions. Please report to the Obstetrician ASAP. You need to be on the bed and put on uterine relaxants like Albuterol and Rotational preparation like Austen for maintenance. Once the uterine contractions have subsided, then also you should continue to take bed rest. You have yet not completed 28 weeks. So the possibility of week mouth of the uterus (incompetent cervical internal OS) should be ruled out; though it usually does not cause painful uterine contractions for prolonged period. Incompetent internal OS needs cervical stitch for reinforcement which is removed just before delivery. I hope you will take quick action to report to the Obstetrician. </s>

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

<s>[INST] I would like to understand my MIBI stress test results Findings: The overall quality of the study was Adequate. SPECT images demonstrate small mild anterior perfusion defect on stress images which non reversible at rest, however normal wall motion is seen, as well as breast shadow and vertical patient motion. Gated SPECT images demonstrate normal wall motion. Left ventricular ejection fraction was calculated to be 67% at rest and 65% post-stress. [/INST] Hi I have gone through your question I think you are worried about that small fixed defect it indicates some previous ischemic insult which result in scar myocardium but as the area is small one and by small I will assume it's less than 5% only involve one arterial territory and not effecting your overall ejection fraction take your cardiac meds and exercise and less cholesterol regular check up with your physician and don't worry remember once defect is fixed the myocardium cannot be salvaged thanks hope answer your question </s>

<s>[INST] Hi, I have been suffering from tightening pain just below my right breast for almost 2 years now. For a while there the pain just seemed to disappear, but as of late ; the sharp, stabbing to constant pain comes around more frequently. I do suffer from allergy induced asthma, but have never been in this much pain and discomfort.... Cancer does run in my family....... Is it time to be more serious about this and finally bite the bullet and go see a doctor? [/INST] Hi, dear I have gone through your question. I can understand your concern. You have stabbing pain in your breast. It can be muscular pain, some chest pain or pain due to your breast pathology. If I am your treating doctor then I will prescribe you analgesic and muscle relaxant Chat Doctor. If pain remains persistent then I will ask for further investigation like chest X-ray and demography. Then I treat according to diagnosis. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using Chat Doctor. Wish you a very good health. </s>

<s>[INST] hello sir. i am nivedita .. i want to discuss about my mother .. she is 50 year old .. she is nt normal or behaving normal from some 3 years.. she has changed alot she s not taking proper food and rest .. used to pray alot and behaves very rudely ... whatever we do she always gets irritated.. she refuses to see a doctor and dnt accepts that she is not well.. she is litle stubborn since her childhood but now she used to get aggressive for her stubbornness.. she used to mind each and every thing and feels insulted for no reason.. she dnt take much care of hygine and do whatever she feels correct .. never listens to anybody and used to argue.. other than these things there are many more she used to do .... please suggest what is she suffering from and what can we do for her .... [/INST] Hello and welcome to Chat Doctor. Thanks for your query. I understand your concern regarding your mothers psychological problems. Now, increased irritability and anger, mood changes, poor food intake, poor self-care, etc. in elderly persons could be indicative of a depression. However, we need a detailed history and a proper psychological assessment to make a definitive diagnosis. I would suggest that you take her to a psychiatrist for a detailed psychological evaluation and further management. Don't worry, there are effective treatment options - in the form of medication or counselling / psychotherapy which will help overcome you mothers problems. Wish you all the best. </s>

<s>[INST] When I go to bed my feet become very very hot and turn bright red it s unbearable. Nothing seems to help i have to sleep with ice packs in my feet. They even become swollen. I have to get up and put my feet in cold water. What could possibly be wrong? I have severe fibromyalgia could that be a cause? But I ve had that for years now and never had this problem. [/INST] Hello, Fibromyalgia cannot cause burning in the feet directly. Burning in the feet is directing us towards the uric acid issue. Which needs some attention and diagnostic test. If the test is negative then we may have to check for lumbar spine MRI and rule out the pathology associated. It can be due to high levels of uric acid or either its due to lumbar spine pathology. Hope I have answered your query. Let me know if I can assist you further. Jay In Chat Doctor. </s>

<s>[INST] Can you please advice the reason for this? hi I was diagnosed with probable Multiple Sclerosis 3.5 years back. Recently since last one week I could sense some numbness on the right side of my ear with slight pain in the right ear. The numbness has decreased but I can find stiffness in my right hand can you please advice? [/INST] Hi, Multiple sclerosis can cause the neurological symptoms, but it is more at the lower limb side, upper limb involvement is less common. Ear pain (Nostalgia) may not be due to multiple sclerosis, but it could be due to impaction of wax, and it needs to be ruled out. For the upper arm stiffness cervical spondylosis could be the cause, but it may not be due to multiple sclerosis, Hope I have answered your query. Let me know if I can assist you further. </s>

<s>[INST] my 19 month old is like any toddler happy and not a worry - however noticed yesterday when changing her for bed she had a small lump to the left of her belly button, size of a marble and it was a blue colour. This morning the lump is smaller and the colouring has spread to the size of a 20 cent piece and is now a bruise like colour. Wasn t sure whether this was good or bad. Thinking maybe she has just fallen over and hurt herself, and hence got this lump which is slowly clearing [/INST] Hi ! Good evening. I am Chat Doctor answering your query. Yes, this could have been caused by a trivial trauma, and now the hematoma started getting absorbed. However, if that did not clear in a weeks time, I would advise you to get it clinically assessed by your pediatrician/general surgeon in your area. I hope this information would help you in discussing with your family physician/treating doctor in further management of your babies problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing Chat Doctor to clear doubts on your health problems. I wish you an early recovery. Chat Doctor. </s>

<s>[INST] Hi, for 3 years now I have been getting a rinny nose clear fluid and before I know it my bronchial tubes feel full and I am wheezing. Last year this went on for months. I went to doctor and received z pac meds and breathing albuterol 2.5 and none of these helped. I thought it could be my thyroid meds and changed. Now I have the wheezing again this year while Im up in North Carolina mountains. I am from Florida. What could be going on that this gets in my bronhcials and its hard for me to breathe. I am healthy and take vitamins and only one prescription for thyroid . I went to drug store and he recommended tussin dm,allergy relief and said I might have developed algeries. [/INST] Hi Dear !! Thanks for your query to Chat Doctor. Read and reviewed your query and health concerns. IN the given situation of Yours, seem to suffer from-Allergic Rhinitis with? Bronchitis. Other causes like -hidden TB infection /Tropical Pulmonary Eosinophilic and need to be ruled out by Second opinion with Chest Physician. Treatment-Would be with-Singulair(Montelukast)/ albuterol aerosols puffs/Plenty of fluids / and antibiotics to control infections/It Plex for fast bronchial recovery. This plan would reduce your dilemma about running nose with wheezing bronchial tubes. Hope this would help you to plan further of this complex illness of yours. If need be, update any health issue 24 x 7 by a direct question to ME, at following Chat Doctor link-Dear, if satisfied, Dont forget to close this query with YOUR pleasing feedback comments to rate this reply and service, to boost the morale of incoming Emergency patients like YOU, at Chat Doctor services. If you want to update more details and ask more update queries, You are most Welcome herewith !! Good Day!! Wishing Good Healthy Life in time to come!! Chat Doctor. N. Senior Surgical Specialist. S. Genl-CVTS </s>

<s>[INST] Born with Hemangioma Vascular Malformation to the Left of my face (Internal & External) Cheek, bottom lip, tongue, to the back of throat. Can this cause shortness of breath? I am now 44, but had been treated in my late 30s from my Plastic & Radiologists Surgens. (NZ Maori Female - Gabe) [/INST] Thanks for your question on Chat Doctor. I can understand your concern. Hematoma is benign tumor of blood vessels. It can be seen in all organs like lungs, liver, kidney, spleen etc. but commonly seen in face and mouth. In lungs, this Hemangioma can cause arteriovenous shunting of blood. This means, Hematoma causes mixing of oxygenated and deoxygenated blood. So body will sense low oxygen and so increase respiratory rate to compensate. So Hematoma in lungs can cause breathlessness. So better to get done CT pulmonary angiography and if Hematomas are there then you will need surgical removal of these Hematomas. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. </s>

<s>[INST] my doctor thinks I may have a hernia, i did have a c-section 2 years earlier. I found a small knot and thats what took me to the dr., although I have a lot of pain in that area as well mainly during my period which I think may be do to endometriosis in my scar tissue since it only really hurts during my cycle. I am a big worrier, I have a ct scan scheduled for Wed. Could it be ovarian cancer though without prior symptoms or anything coming back on pelvic and yearly exam? I am 37. [/INST] Good morning. First you should not be unnecessary worried thinking you have got ovarian cancer. Ovarian cancer is usually not detected in early stage. When it causes symptoms, it has already reached 3rd stage. The symptoms are heaviness in the abdomen distension of the abdomen, bloating sensation vague discomfort or pain.However, these symptoms may or may not be due to ovarian cancer and must not cause undue worry. Regards </s>

<s>[INST] My son has been feeling tired for a couple of weeks. I took him to the doctor because he had not been in about 3 years (he s 19). He is 6 ft and about 165 pounds. He has also been taking a mass gainer and another supplement with creatine. They did a complete blood panel on him. The doctors office called today and said his liver function was high.....ALT 107 and his AST 61. what does this mean? Could it be from the Creatine? [/INST] Hi...just elevated liver enzymes of this level of what you quote without any other associated symptoms cannot be correlated with the liver enzymes alone. Elevation of liver enzymes is of very non-specific value and does not mean anything unless it is being corroborated with other disease evidence which you query doesn't mention anything about. As of now if I were you treating pediatrician I suggest - you need not worry about this liver enzyme. Regards - </s>

<s>[INST] I had a broken tooth they had to do a root canal on. Now the oral surgeon said the tooth on either side is dying. They did a root canal on one and will probably do the other on Monday. My concern is now a fourth tooth is feeling pain, the next one in line. I wonder if I need to see an MD about nerve damage or bone issues. [/INST] Hello, I completely understand your concern about the toothache. Dental pain surely annoys you. Reading your question, I guess you have a high carries index which is why the dentist has suggested you for a root canal treatment. There would be a deep cavity in your tooth which is why you feel the pain. I do not suspect any bone or neurological damage. Get your dental x-ray done and depending upon the depth of the cavity, the doctor would suggest you to go in for a simple filling or a root canal treatment. The earlier you visit a dentist, the better it is ! Hope this helps. Take good care </s>

<s>[INST] hi, I am a male 55 yrs. partially paralyzed incomplete quad wheelchair bound 37 years spinal cord injury. I have had a foley catheteter 3 months I HAVE no fever or feelings of sickness but im getting a fair amount of blood coming out of my penus when I move around. Should I call 911 or wait call doctor tomorrow [/INST] Hello! I understand your concern. In my opinion the troubles you have may be caused by physical damage to your urinary ways. It is the trauma caused to these ways by the catheter during movement or traction. I think you should go to the doctor as soon as possible to have a physical examination, a routine blood test, a urinalysis and an abdominal ethnography. This situation may cause anemia or urinary infection. You may need change of the catheter or further examination by a urologist to find out the problem.In the meantime I would recommend you to avoid every movement of the catheter because it can cause further damage. Hope to have been helpful! Thank you for using Chat Doctor! Chat Doctor. </s>

<s>[INST] Hello Doctor, My friend has been recently diagnosed for kidney failures and suggested go for kidney transplantation . Can I please let me know the best hospital in Bangalore which has conducted successful transplants? also a doctor s name as reference if possible. what is approximate cost of transplantation? Thanks in advance for your inputs/advice. [/INST] HelloThanks for your query. Your fried is diagnosed with Chronic Renal failure and advised to undergo renal transplant. If you are planning for Renal Transplant would suggest choosing the related Donor as the results of transplant are more encouraging if the donor is related to the recipient. As your query about the best center in Bandolier I would suggest you to consider Forts Hospital and Chat Doctor. </s>

<s>[INST] Hi My name is Melissa and Got into 2 major car accidents and damaged my back...i have 2 herniated discs back spasms and some days it feels like electricity shooting down my legs. im in pain everyday and motrin doesnt work at all...what other pain reliever can i take to help me with this problem.???? [/INST] Hello, I have studied your case. Medication like methylcobalamine with muscle relaxant and analgesic will reduce pain; you can take them consulting your treating doctor. You may consult physiotherapist for further guidance. He may start TENS, or ultrasound which is helpful in your case. I will advise checking your it B12 and it D3 level. As MRI shows disc compressing on nerve root then surgical decompression is permanent solution. Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Take care. </s>

<s>[INST] HI DOC...I HAD ANAL SEX FOR THE FIRST TIME AND BOUT THE NEXT DAY I HAD A BIT OF PUSS ON MY SCROTUM...AS DAYS WENT BY IT GREW INTO A HUGE BOIL WITH BURING SENSATION, PAINING WHEN I TOUCH IT...I KNOW ITS AN STD...WHAT CAN I DO FROM THIS POINT? ITS LIKE HAVING THREE TESTICLES [/INST] HelloThanks for query. You have developed Boil on scrotum after having anal sex. Please take antibiotic like Augmenting along with Diclofenac twice daily. For 10 days.If it does not subside or turns into an abscess you may need to consult qualified General Surgeon to get it incised and Chat Doctor. Ensure to clean and wash the genital area with warm soap water twice daily. Get basic screening tests for STD and HIV done to be rest assured about acquiring the same. </s>

<s>[INST] I got operated for ca-rectum in June 2012 in AIIMS New Delhi , after that I had 25 radiotherapy & 6 chemotherapy . Now pain occurs in my right hip which extend to my testis , Doctor suggested for MRI of right hip which found to be normal but pain is still in my right hip . Kindly suggest some remadyRegardsJoginder Kumar Sharma 0000 YYYY@YYYY [/INST] Hello! Thank you for the query. Such symptom does not have to be associated with your cancer. Hip pain, radiating to the testis can be simply caused by urinary tract infection, urinary tract stones, testis inflammation or prostate inflammation. If the pain has started after the surgery, some nerves in the operated area (quite common complication) could have gotten harmed. I suggest you to have urinalysis and testis inflammation first. In case of urine infection, antibiotics should be prescribed. Hope this will help. Regards. </s>

<s>[INST] I am a male 79 years old, have brief chills the may sweat have had for about 2 months also white blood cell count to high had bone marrow test and ok so far dr has no idea what is wrong when I chill have no fever as I check that and blood pressure. thanks [/INST] Hi, From history it seems that you require evaluation of your case. As you get chills often and WBC is high it indicates there might be having some infection in your body giving this problem. Consult your doctor and go for,1, X-ray chest,2, ultrasound abdomen,3, complete urine check up.4, Blood checking for RFT, LFT and other tests. After all reports, one can have clue about your problem, and then they will go for treatment accordingly. Ok and take care. </s>

<s>[INST] O have been having pain in the outer side of my left foot. It starts at my heel and goes to the middle of the outer foot. Reading up it sort of seems like plantar fasciitis but it is not on my whole heel...just the outer edge of the heel and outer edge of the foot and it does not affect my tors. Hurt most first thing in the am or if I have been sitting for a long period of time and get up to ealk. I went out and bought $160 sneakers because I thought it was my shoes and it made no difference. [/INST] Hi, Your symptoms are pointing towards the possibility of plantar fasciitis. Plantar fasciitis pain may be on the bottom of the heel or on the outer or inner side of the back of the heel. Pain is more in the morning as you said and decreases as the day pass. The initial line of treatment is soft heel cushion in your shoes and calf stretching exercises before getting out of bed. The hot wax bath helps in reducing pain. Tablet Diclofenac Sodium for pain relief can be taken. If this all is not helping local injection of Depose Chat Doctor. Visit an orthopedic surgeon for a detailed clinical examination is recommended. Hope I have answered your query. Let me know if I can assist you further. </s>

<s>[INST] I have SLE , and for the past two months I have had cold or allergy symptoms that will not go away... sneezing , sinus headache and pain, feeling of something stuck in my throat. I took a 2 week round of antibiotics, but the symptoms are still there. Is there something I can do to relieve these constant annoying symptoms? [/INST] Hello Linda, Your symptoms would be consistent with persistent rhinitis/rhinosinusitis that can also cause upper airway problems with secretions from the sinuses. The SHE in the background would mean you are either on steroids or immunosuppressants and therefore fungal rhinosinusitis may require to be excluded. A CT Paranasal sinuses is recommended. The treatment would involve: long-acting oral antihistamines with fluticasone or mometasone nasal spray 2 sprays per nostril twice daily. The link with SHE is possible particularly if it is active, and blood tests such as complete hologram, Lots, C3 C4, DSNA levels would be required, and the condition is SHE related angioedema of the upper airway. Your Rheumatologist would be the best person to get in touch with if the tablets and nasal sprays do not help. Best Wishes. </s>

<s>[INST] My wife had hormones imbalance , we are getting treatment in china.foctor daignos some problem in overies size, due to which my wife isn t getting pregnant, she suggested some injection, written on paper in Chinese. I have translated which gave result sodium choloride would you please let me know the purpose of this injection. If I translate it right [/INST] Hello, There is no evidence regarding the use of sodium chloride in pregnancy. I suppose the Chinese script wrongly interpreted. Maybe your doctor meant your wife has polycystic ovaries which need some medication to help her get pregnant. So please ask your doctor details about the condition and treatment she is undergoing. Hope I have answered your query. Let me know if I can assist you further. </s>

<s>[INST] Hello Dr. my name is kiki I am iregular 31 years young about to be 32 i am unable to concieve i was diognose with ovarian cyst almost a year ago i was suggested to have an operation in order to concieve but it was not a guarranteed what would you suggest i was married but seperated i m starting to feel guilty about this.pleasse help any suggestions? thank you [/INST] Hi KIKI, If ovarian cyst is the only pathology that is stopping you from conceiving, then there are treatments available. Depending on the number of cysts and the size, treatment is either medicines or surgery. A single large cyst more than cm may require surgery but smaller ones can be treated with OC pills. You should get a fresh scan and seek a second opinion for infertility treatment if you really want to conceive. </s>

<s>[INST] Hi sir i am worrying i am only 21 yrs old female i had always experiencing low potassium 2.0 i admit in the hospital 3 times this year because of low potassium and at the same time my creatinine range in 94.70 which is high the doctor said. What will be your advice for me that i am always experiencing low potassium. I loss weight and when hypokalemia attacks me i felt temporary paralyze. Pls help me is there something wrong with my kidney. Is 94.70 cretinine is normal for me? Wat are the foods allowed for me? Thank you so much [/INST] Hi, Thanks for writing in. Low potassium or hypokalemia, especially if persistent, can induce a variety of changes in renal function, impairing tubular transport and possibly inducing chronic tubulointerstitial disease and cyst formation. Diet modification is recommended for you. High sodium intake tends to enhance renal potassium losses. Therefore, taking a low-sodium, high-potassium diet is best for you. Avoid extra salt in foods. Bananas, tomatoes, oranges, and peaches are high in potassium and can be included in your diet. </s>

<s>[INST] I have taken zimig250mg for one week but ring worm agin appear after few days then i take again one weak after few days it back again then doctor said to take one doze more ihave taken but after few dsys it appears in some extent ..what will i do can i repeat the same [/INST] Hi, Thanks for contacting Chat Doctor. I have gone through your query,"limit" is the brand name of antifungal medicine terminating. Zimig is very effective for ringworm infection, We prescribe once daily or twice daily dose according to the severity of the infection. As you are having recurrence, you can go for twice daily dose. Use a topical antifungal cream along with the oral medicine. Clotrimazole is a commonly used for local application. Try this after having a word with your doctor. Hope it will work. Wishing you all the best. Thank you. </s>

<s>[INST] Hi this is AAAAA from bangalore. My friend got some problem . He is 38yrs old. 2 days back he got sudden rashes on his left part of face and it is burning. 2nd day it bacome red coluor. and 3 rd day ie., today it become complete black colour. only on his left part of face and slightly passed to left side of neck . Still it is burning. and it is severe in day time when exposed to sun light and even in house. This is first experience to him. what could be wrong and why it is so. [/INST] Hi, Thanks for writing here. It seems your friend has got severe sun allergy. Ask him to stay indoors as far as possible. Do not apply any soap over affected area. Ask him to apply ice or cotton cloth soaked in water. Start applying a steroid cream like mometasone over affected area two to three times daily. You can also give him anti-allergic tablets like cetirizine at night. In case there is no improvement it will be better to consult a dermatologist. Hope this will solve your query. Take care. </s>

<s>[INST] Hi, well this is hard to explain, my gum is a little swollen and it hurts, only in one spot though, in the very back, and i noticed that between my tooth and the gum there was something stuck there, as soon as i take it out it was something white that didn t have a normal smell, i don t know if it could be rests of food or what, i need help, also i would like to know, i ve been very paranoid because some of my tooth feel just a little bit loose, should i be worried? [/INST] Helloit seem your gums have got highly inflamed called gingivitis. This occurs because of food accumulation in between gum sand teeth because of improper cleaning under the action of bacteria gums get inflamed leading to swelling tooth loosening bleeding foul smell. White hard material may be calculus, it is a calcified structure stuck on tooth in case of bad oral hygiene.I would advise you to go for deep cleaning of your teeth called scaling, use Betadine mouth rinse twice daily and learn the proper brushing technique. Regards Chat Doctor. </s>

<s>[INST] i went to a dentist the other day for a infected tooth, which i had taking a round of penicilin for and it wasnt infected anymore just real sensitive,he didnt pull the tooth he put me on amoxicilin for 7 more days,im concerned about taking all theses antibiotics,plus he made my next visit for 23 days later.and put a refill on my amoxicilin and said take those if i needed to,what do you think about this? [/INST] Hi Dear, Welcome to Chat Doctor. Understanding your concern. As per your query you have infected tooth. Well there can be many reasons for symptoms you mention in query like tooth, abscess, pulpits or gingivitis. I would suggest you to consult dentist again as you have already fixed appointment. Doctor may perform oral prophylaxis. Doctor may order x-ray of tooth to confirm the diagnosis. Doctor may also check the tooth for tenderness and check level of infection. If infection has already affected the pulp then doctor may recommend root canal therapy along with crown on it. For now do warm saline rinses several times a day and maintain proper oral hygiene. Hope your concern has been resolved. Get Well Soon. Best Wishes, </s>

<s>[INST] I had a girl do oral on my penis and there was a clear build up of smegma under the forskin and ridge of the head. I dont think it was from phimosis I retracted it late just id never been taught it could retract and that i should be washing it ( I blame the parents :p)since i have kept it clean and dry. But i have always had almost like red lips around the uretheral opening and a very red frenulum. When I am erect the forskin goes back over the head okay but sort of bunches up a bit behind the head. i can stretch it a bit further but then it can be a bit sore. I have a redness next to the frenelum. What should i do about all this ? [/INST] HelloThanks for your query, based on the facts that you have posted it appears that you have developed inflammation of terminal part of urethra and external urinary meats due to Aral sex that you had from your girlfriend. As oral cavity is full of bacterial flora it is the prime cause of getting infection of glans, and meats. You need to take broad spectrum antibiotic like Čeferin along with anti-inflammatory Chat Doctor. Along with topical antibiotic ointment like Newsprint twice daily. Ensure to wash your genitals with warm water twice dailyEnsure to avoid sexual encounters till it heals up completely. </s>

<s>[INST] hello, i take 5mg of ramipril daily and have started having severe paid and discomfort in my left knee, have had xray which suggests just wear and tear, but by end of day i am i real pain, could this be linked to ramipril and if so what can i take to reduce the pain, many thanks [/INST] Hello, ramipril has indeed been linked to joint and muscular pain, but this is an uncommon side effect. Your doctor should first exclude other potential causes and only then attribute any symptom to April. The only way to find out is to stop April - let your doctor prescribe another Chat Doctor. If the symptoms recur then April would have a high chance of being the real offender. I hope I've answered your question. Please let me know if you need further assistance. Kind </s>

<s>[INST] hi,myself deepak 35 yrs,due to infection after burn a cyst has developed and gradually increasing under my armpit,due to this my ulnar nerve is uneasy,itching and pins,needles feeling is there and in hand also.what should i do.now it is around 1.5 cm in dia. [/INST] Hi ! Good evening. I am Chat Doctor answering your query. This could be an abnormal scar otherwise known as keloid, which is causing the problem. Even though it needs a physical examination to diagnose it with certainty, I would suggest you not to scratch it though it might itch to prevent its spread. For the present you may go for an anti-inflammatory, and an anti-allergic Chat Doctor. I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing Chat Doctor to clear doubts on your health problems. I wish you an early recovery. Chat Doctor. </s>

<s>[INST] hello doctor,my mother is 58 and she has been suffering from a spinal infection for the past 3 yrs and she is on ributin and catbutanol(i am not sure of this tablet name alone) and her mri which had been taken in dec showed very slight traces of the infection. the esr levels are 105 which is higher than before. she is also on catheter for the past 3 yrs and also suffering from arthritis as well. i dont think the esr level can increase because of the infection because she is having good appetite and she is not having fever which she used to have when she suffered from heavy infection.. What could be the reason for the raised ESR levels. [/INST] Hi, dairy have gone through your question. I can understand your concern. There are many causes of high ESR. Tuberculosis, infection, anemia, autoimmune disease, paraprotienemia, malignancies all can lead to high ESR. You should search the cause. She is having arthritis. You should investigate FOA any autoimmune disease. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using Chat Doctor. Wish you a very good health. Don't forget to click, thank you. </s>

<s>[INST] my daughter has been sick for 1 month she is 10 years old she had a ct scan which showered mesenteric lymph node adenitis. She has lost 21 pounds she is in constant pain she was seen by GI this past friday and they have set her up for colonoscopy and EGD. The pain increases after she eats and after she has a bowel movement and her bowel movements have had mucous in them. What could this be please help???? [/INST] Hi. Thanks for your elucidate history. Young child of 10 years loosing so much weight and have Mesenteric Lymphadenitis and symptoms of bowel movements with mucus and has to go after food is suggestive of Tuberculosis of the abdomen / or a Cancer like lymphoma.IT is good that she will be subjected to Colonoscopy that biopsy can be taken if a lesion is seen in the colon. EGD for secondary changes. The best diagnostic tools in such a case are :Blood-complete blood picture, kidney functions tests, blood sugar fasting and post-lunch, Urine-routine, microscopy, culture and sensitivity (before start of antibiotic)Diagnostic Laparoscopy with FNAC or preferably biopsy of the lymph nodes will give a definite diagnosis. So that a proper treatment can be started ASAP </s>

<s>[INST] Hi,My son is 4.5 yrs old and is suffering Allergic bronchitis since he was 6 months old. we have been seeing paedetrician since then. He has been subscribing Levolin / Budescorf. He gets this attack once in almost every 15 days. Sometimes its very acute. He coughs relentlessly. He doesn wants to take any oral medicine. even if we force onto him he vomits. We have been curing him with Levolin (0.31/0.63) nebulaisation. We have been observing, since last one month, the intensity of attack is very high and he generally takes 3-4 days to recover. We have been taking Homeopathy medication too. This is too often nowadays. Please advise / help [/INST] Hi, thanks for your query. I do understand your anxiety in getting your child treated for so long. I would advise him to start on Stalin MDI 2 puff 4 times a day for 3-5 days with will tie over his acute scenario and Saber MDI 2puff twice daily for 6 months which will act to prevent his exacerbation. He can also be started on montelukast 5 mg once daily for at least 2 months. Hope this answers your question </s>

<s>[INST] I have lower back pain, my mri report said minimal disk bulging at l3-4 is seen impinging upon the thecal sac. mild degenerative disk disease is seen and l3-4, l4-5 with signal alteration. facet degenerative changes at l3-4, l4-5 and l5-s1. the dr who I sent my mri to (a va dr). had his nurse call me and told me to quit complaining, there was nothing wrong with my lower back. the va dr never saw me or ask me any questions.. what can I do to lower my pain levels, as they affect my everyday living. I can and do receive pain meds at my local hospital. dont tell me about shots in the lower back (over 30 times)cant do that any more. [/INST] Hi and thank you so much for trusting us with your health query. I am so sorry to hear about this persistent pain. If the current doctor would not attend to your repeated concerns about this pain, I will suggest that you get a second opinion from another physician. Besides, your pain medications should be titrated to a level that permits a pain free life to improve the quality of your live. This can be done with powerful medications. Also try physical therapy, and get a neurosurgeon consult to evaluate for the possibility of surgical management. I hope you find this helpful. Thank you so much for using our services, and please feel free to for more information or clarifications if need be. I wish you the best of health. </s>

<s>[INST] I have been recently tested for low B12 levels because I have been having leg pain. Now for the past two weeks I have been having dizzy attacks and feel like I could actually pass out for a second or two. My B12 level was 278. Could this be the cause of my dizziness. I also have a headache when this occurs in the sinus area of my face. [/INST] Hello dear friend, I can sense that you are getting anxious about your vitamin B12 levels, but 278 is not low but within normal range(towards lower side but still above the defined limit for low levels as anything above 200 is normal). Even if low, it would have caused symptoms related to anemia(usually pallor, fatigue, palpitations,breathlessness) or neurological deficits like impaired joint position, inco-ordination of body parts, limb weakness or stiff legs. In my clinical experience of a few years, I have not encountered patients of B12 deficiency causing prominent leg pains or people getting episodes of dizziness due to vitamin B12 deficiency(dizziness although you may be a part of anemia sometimes). I would suggest you to go to a neurologist, and he will, after analyzing your history and examination, will tell you about the possible causes of dizziness in your case, which can be several otherwise, like postural hypotension, positional dizziness, some ear pathology and a few others. I hope it helps you. </s>

<s>[INST] I have a lmph node under my left ear,my left ear crackles and pops when I breath,and pain in my left shoulder for the last month,and I also have the worst dizzy spells I ve ever had, to where I feel like I m gonna pass out. So bad I have to close my eyes. The doc I don t think either cares or didn t hear what I told him. Is there a bug of some kind going around? I m 63 and have never had dizzy spells like this . I m afraid to drive alone. [/INST] Hi, dear. I have gone through your question. I can understand your concern. You may have some upper respiratory tract infection. That's why your lymph node is enlarged. You should take a course of antibiotics with antihistamines according to your doctors' advice. If it doesn't respond to treatment then biopsy diagnosis is advisable. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using Chat Doctor. Wish you a very good health. </s>

<s>[INST] I want to make my partner perganent, Can u advise me wat time and wat position i ve to do and one more thing before i used coconut oil for lubrication but in last two i hadnt used any those times i was bleed in my tip of penis.Can u suggest me which one is good, also my reletive pushing us by asking any good news [/INST] Hi, First make it clear that there is no problem with you and your partner. Go for your semen examination and full GAEC check up of your partner. If these reports are fine then go for sex between 10th to 20 ETH day of her period cycle. Do not use any lubricant. Go for foreplay for some time before intercourse to excite sexually your partner so that there will be enough secretion of vaginal canal giving good lubricant. After sex do not allow your partner to go for cleaning or washroom for an hour. Put pillow below her back after sex to prevent semen coming out. Ok and take care. </s>

<s>[INST] My husband has had two vaesectomies now! The first one was done under local and the results came back that there was still semen present, he was told he would have to go under general and have a second procedure. He did this a year ago and we have been chasing the results ever since. It hasn t been an issue as I ve had the coil but due to medical reasons I have had to have it removed. We managed to contact the consultants secretary today who told us that there was occasional non motile sperm in my husbands samples. The consultant at the time told my husband that they had cut away quite a chunk of the correct tube, they had it analysed and it was the correct tube they cut away. But his sperm results said occasional non motile sperm [/INST] Hello dear, Thank you for your contact to Chat Doctor. I read and understand your concern. I am Chat Doctor answering your concern. You can take the opinion of the second doctor. Usually with the single operation all the sperm will go on. But as you have still non-motile sperm that means you have not been performed with good surgery or there may be some problem in the surgery conducted. Once you check with second all your doubts will be clear. Please be aware as this can make you pregnant. Appropriate contraceptive measure is must till we receive clear report from the lab showing no sperms in the system. I will be happy to answer your further concern on bit.ly/ Chat Doctor. Thank you, ChatDoctorInfectious diseases specialist, ChatDoctor </s>

<s>[INST] Hello, please I discovered that I ve some wound on the tip of my penis which is giving me sleepless nights, I ve not had sex with any woman for close to 6 months now so I don t know what could be the cause, I took ill and treated malaria immediately I got well I discovered I had cramps around my nose and lips which is normal for me after malaria but the one around my penis cap is giving me worries because I wouldn t say its an STD since I ve not had sex for close to 6months.......pls advice me. [/INST] Thanks for asking in Chat Doctor forum In short: Is it wound due to injury or is it ulcer like lesion? Explanation: There are many STDs(ex. syphilis) which can cause symptoms or get activated even after 6 months. So, do not think of malaria or any other thing. If you have a lesion on your penis, then visit a doctor without hesitation and get yourself investigated for the cause of the lesion. Good luck, hope this will help you. </s>

<s>[INST] my husband woke up with severe pain at his left lower side abdomen he is complaining that his testicles hurt along with his left leg going numb. He is a tough guy and is screaming in pain crying. Please help us to know what is wrong, we are stuck in an ice storm and cannot make it to an ER [/INST] Hello, Apply ice. Ask him to use tight underwear as it can sometimes relive the pain. He can try taking painkillers. However, if the pain persists even after all these, I will suggest NOT to delay treatment as it may indicate "Torsion of the testes" which is a serious issue and needs immediate medical attention. Other causes may be infection, kidney stone and simple muscle spasm. Hope I have answered your query. Let me know if I can assist you further. Take care </s>

<s>[INST] My husband had a triple by-pass 10 weeks ago. These past few days he is complaining of severe back, shoulder pain and pain if he tries to take a deep breath. His BP, pulse rate, and temp are normal. The pain radiates to his chest but is not coming from his heart. Could he have pluerisy? [/INST] Hello, I had gone through the case and found that if there is doubt of pleurisy then go for Echo of lungs and find the cause. If no then go for vitamin D3 test AMD it might be only muscle spasm. So go for test then take treatment. If only muscle spasm then take mild painkiller and apply muscle relaxant gel and also take Vitamin D3 once a week for 3 months. Hope my answer will be effective for you. Thanks </s>

<s>[INST] Hello. I have had a question about this for quite a while now. Ive had this condition since I was younger but up until about my sixteenth birthday nobody had noticed it but me. My chest, at least the left side, is drastically more pushed out by the bone than then other side. every now and again it hurts but nothing so extreme that I cannot move or function. Is this dangerous? And is there a procedure that can have this removed or taken care of? [/INST] Thanks for your question on Chat Doctor. I can understand your concern. In my opinion, you are having spinal deformity which is giving appearance of big left sided chest pain. This kind of deformity can cause musculoskeletal pain. So better to consult orthopedic doctor and get done clinical examination of rib cage and spine. You will also need MRI of rib cage and spine. If this is suggestive of deformity then you will need surgical procedure to correct it. But if it is normal then nothing is needed. Apply warm water pad on affected areas and take painkiller like ibuprofen. Don't worry, you will be alright, consult orthopedic doctor and discuss all these. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. </s>

<s>[INST] Hi i have been taking lasix for almost a year now 3 times a day in total 120mg i am planing to get pregnant i asked my doctor he said i can stop it and i can get pregnant the next day since it diesnt stay in your system.But reading on the net some says that it is harmful and it stays in the body system. [/INST] Hello, Taking lasix has nothing to do with your pregnancy. It may have a very little on induction of pregnancy. But once you are pregnant, you need to leave it. I hope you are taking lasix under a prescription which is being reviewed regularly over a few months. If not, do consult a doctor for re assessment of need for lasix. Hope I have answered your query. Let me know if I can assist you further. </s>

<s>[INST] Hi my wife is 23 weeks pregnant and she is having UTI . since 4 months got reports also it says organisms isolated is Klebsiella species Colony count is >100000 CFU/ML Significant growth,Sensitivity pattern Netilmycin sensitit(24mm)CIP,OF,PTI,Gen,AK,IPM,LM,---SensitiveAMC AMP, CTX, CAZ,CTR,CPZ------RESISTANCE PLEASE advice HOW TO CURE IT. [/INST] Hi I do care for your concern. Your history suggest of urinary tract infection that needs intervention. Since she is in six months of gestation Chat Doctor. However, it is advisable to consult your obstetrician and know about different treatment option and adhere to one, regular follow up is a must. Using antiseptic soap and clean undergarments will add to the help. Hope I have answered your question, If you have more feel free to ask. Thank you. </s>

<s>[INST] Ok, Ive been dealing with burning chest pains, ive had foam like saliva because of it, i randomly have stomach pains like i might vomit, and sometimes when Im by myself my legs will randomly give out on me when i stand for too long.. Im only 21 years old, what the heck is wrong with me? [/INST] Hello, Thank you for asking at Chat Doctor. I went through your history and would like to make suggestions for you as follows:1. As you have burning chest pains, salivation, nausea and stomach pains, I would think of causes like gastroesophageal reflux syn Chat Doctor. 2. I usually suggest my such patients antacids like omeprazole or sanitizing 30 minutes before meals.3. I would suggest you to avoid hot/spicy foods, caffeinated beverages, alcohol and smoking.4. If this does not help you, I would suggest you to consult a gastroenterologist who will examine you and may suggest YOY some investigations.5. Inability to stand for long may not be related to other symptoms. Hope above suggestions will be helpful to you. Should you have any further query, please feel free to ask at Chat Doctor. Wish you the best of the health ahead. Thank you & Regards. </s>

<s>[INST] My grandson has had a cold for the past week. Very low grade fever at the beginning of the cold, and now has Green eye bugers when he wakes up. His eyes are also watery and a bit puffy. No fever or other symptoms. Is this serious, or just a part of a cold and growing up. He is 2.4 years old, no other conditions. [/INST] Hi, Welcome to Chat Doctor, Eyes getting slight puffy is normally seen in some child Chat Doctor. As long as it subsides after a little while it's OK. Watering of the eyes with puffiness can happen if the child has hot some infection in the eyes. That is usually associated with redness of eyes. If you don't see that then nothing to worry. If the puffiness increases or is very prominent and lasts longer then he needs to be seen by a pediatrician. Hope this advice helped. Take care. </s>

<s>[INST] hi. me and my boyfriend had sex (with condoms)on the 3rd of this month and since 4rth I have a weird abdominal pain in my lower left side. and also there vaginal egg white type discharge seems to have increasd. Will this fix on its own or is this something dangerous? [/INST] Thanks for your question on Chat Doctor. In my opinion you are having infection in your vagina. Positive findings for infection in your case are1. Whitish vaginal discharge2. Lower abdomen pain3. History of sexual intercourse. So get done clinical examination by gynecologist and start antibiotic. Also get done ultrasound examination of abdomen to rule out other causes. Genital hygiene is must. Chat Doctor. Avoid moisture in private part. </s>

<s>[INST] Hello, I am 25 years old. I have a hard immovable lump behind my left ear equalling to the size of a golf ball. I have extreme short term memory loss and tingling of the nose, feet, and hands at times, also migraines that no medicine seems to work on. I m very irritable, and very short tempered. Some blacking out and light headed as well. Does this sound like a tumor or could it just be like a swollen lymph node? [/INST] Hi, dairy have gone through your question. I can understand your concern. You may have some enlarged lymph node or may have some tumor pathology. Your migraine and headache is not related to your lump mostly. You should go for fine needle aspiration cytology or biopsy to search the cause whether it is lymph node or some benign or malignant tumor. Then you should take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using Chat Doctor. Wish you a very good health. </s>

<s>[INST] I am 30 years old and 4 days ago started experiencing PVC and ended up in the er. They were coming at a rate of about 8-10 a minute....I was started on cardizem 30 Bid. I have only taken it once a day because I am so scared..I haven t had caffeine in over a month or alcohol (could I have a glass or two of wine this weekend?) I have seen cardiologist and two neurologist. Normal CT scans and MRI. Stressecho normal. I m terrified and when I have these body shaking PVC I feel like I am about to die. I am also on Xanax .5 as needed. I need reassurance that I am not gonna go into cardiac arrest and to live normally....I used to be so active and now I am scared to even play Wii with my kids.....I also wore a holter monitor for 10 days and all they said was SVT. Please help me understand [/INST] Hi dear your holder said its supraventricular tachycardia and i the first line you have written was experiencing PVC, premature ventricular contraction both are different entities SVT originates in the upper chamber of heart called atria and are usually not life threatening in most of the cases while premature ventricular contraction can even lead to life threatening condition like ventricular fibrillation so kindly attach you written documented reports if you want a use full suggestions off now you stress echo is normal, your holder says you have SVT ...SVT is a broad entity involving simple sinus tachycardia to atrial fibrillation, donor panic, take Xanax as prescribed by your doctor, over anxiety is one of the most important cause of SVT in adults if possible make it clear whether it was a SVT or thanks </s>