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<s>[INST] Hi, I have a question Im a diebetic Type 2. I have seem to have a hard like a pee on the bottom of my right foot by the pinkie toe. Not on the toe but on the foot close to the edge. Sometime I feel pain when walking in sandles. Could it be the shoes. [/INST] Respected user, HiT hanks for using Chat Doctor.come have evaluated your query thoroughly.* This is more likely to be callus formation.* Must consult a general surgeon for the same or at least a high resolution clinical photograph with mobile as an attachment is mandatory to evaluate it more precisely. Hope this clears your query. Welcome for further guidance. Regards.</s>

<s>[INST] hello. I keep getting a strong metallic taste in my mouth, especially behind one tooth, and the tip of my tongue tingles as it would if I had burned it on coffee, but I havent had anything hot. I have not had a change in diet and I am not taking any new medicines. I quit smoking two weeks ago. Any ides on what this might be? [/INST] Helllo thanks for consulting at Chat Doctor.usually metallic taste and tingling sensation results from various vitamin deficiencies.like iron, it B12 ETC, so please consult a general physician for a complete blood check up and treatment,,,If YOU are middle-aged, with stress factor-- it might also be because of burning mouth syn Chat Doctor. .so maybe you are having relapse episode???either ways please consult an oral physician and general physician for a check-up and treatment,hope it helps,take care,</s>

<s>[INST] hi! i would like to know what is the main problem of my husbands semen analysis and what would be the solution. we are trying to conceive for the past 2 years.. here are the results:Volume - 3mlReaction - alkalineViscosity - hyperviscousTotal Count/ejaculation - 55,200,000Liquefaction - >180minSperm Vitality - 35%Motility: after 30mins (PR+NP) - 30% after 1 hour - 25% after 2 hours - 20% after 3 hours - 15%Sperm Type of Motility:1. Immotile - 0% 2. Total Motility (PR+NP) - 5% Progressive motility - 25% Non progressive motility - 70%Total Abnormal Forms (Krugers Clasification) - 30% a. Abnormal Head forms - 15% b. Mid-portion abnormalities - 10% c. Tail Abnormalities - 5%Spermatogenic cells - 1-2/mlPus cells - 1-2/mlRBC - 3-4/hpf [/INST] Hi greetings. Mainly 3 important parameters. 1. sperm density is normal .we need only 16million /ml2. Motility. Rapid progressive motility is below normal, but moderate is ok3.morphology of sperms seems to be normal. Another findings are prolonged liquefaction. I suggest your husband to consult an Chat Doctor. If so treatment can be taken SND motility and liquefaction might improve. Need not worry about single report. There will be variations always. A repeat analysis after 2 months can be done. Hope my answer helps you. Regards</s>

<s>[INST] I am married and it s been two years we are trying to conceive.. I have taken letrozole for 6 mths and for other two months I hav been induced to ovulate by hormone injections, and I have taken rubella vaccination also. Wat further treatment shud I pursue to conceive fast [/INST] Hi, Thanks for writing to Chat Doctor. You will conceive soon. Be stress-free. Along with ovulation induction I suggest you to get your tubal patency done and if that is normal go for GUI. It is intrauterine ingestion of sperms. Here sperms are washed and processed and placed in uterus. This will increase the chances of conception as problem in ascend of sperm is solved. You can try for 3 to 4 cycles of GUI before proceeding further. Hope I have been helpful. Regards Chat Doctor. </s>

<s>[INST] hi i had my wisdom teeth pulled out five years ago. i recently went for a dental check up and the dentist said i have an abnormality on my bottom right side where my wisdom tooth was removed,like a bump he said.so he referred me to a specialist..i have no pain and the bump is not visible when i see inside my mouth..what could this be? [/INST] Thanks for your query, I have gone through your query. The bump over the wisdom tooth region could be a flabby soft tissue or irrational fibrous secondary to irritation from the opposing tooth. Nothing to worry, if it becomes symptomatic then get it surgically removed. It can also occur secondary to any root pieces left while removing the wisdom tooth. Get a radiograph done to rule out this condition. I hope my answer will help you, take care.</s>

<s>[INST] Hi, I just drank half a snapple bottle before realizing it had mold growing in it... I poured the mold into a cup and it looked like phlegm. The tea tasted a little off...sort of sour. Anyway, is there anything I can do now to prevent getting sick. Should I drink water or try to vomit? [/INST] Hi and welcome to Chat Doctor. Thanks for the query. You should do nothing, unless some symptoms such as vomiting, diarrheas or abdominal pain occur., in most cases it won't cause any serious consequences,</s>

<s>[INST] I have a painful burning sensation inside my right upper arm. It is not a muscle pull or strain, I have had those, it feels like a nerve is being pinched. I also have a very bad sinus infection that I was in the hospital for on Monday. Could these be related? [/INST] Hello, As a first line management, you can take analgesics like Paracetamol or Diclofenac for pain relief. If symptoms persist better to consult an orthopaedician and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Take care Chat Doctor. </s>

<s>[INST] My 6 week old fell off the couch. After a few seconds of crying he started falling back asleep. I started feeling parts of him to see if he d react like he was injured but he didn t. He just went back to sleep. What else can I do to make sure he s ok? Is it ok for him to be sleeping now? [/INST] Hi, in cases of head trauma there is high chances of brain injury. There are some symptoms which are found When brain injury occurs like persistent crying, seizures, persistent vomiting, bleeding from mouth or nose. If above symptoms are not present, then most of the time child does not have brain injury. However, it is better to get the child examined by a Euro surgeon, and if required a CT scan of head should be done. I hope this will help you. Take care.</s>

<s>[INST] I am a 41 yr old female, weight 230, 5 5 tall. I have been having a tightness in my chest which gives me a slight cough. I go an hr or so coughing slightly and with the tightness and it goes away and then comes back hrs or days later. My over all health is good. I don t smoke and never have. I don t drink or do drugs and never have. Can it be anxiety or from being over weight? [/INST] Hello Chest tightness need proper evaluation. It is important to rule out cardiopulmonary reasons. It may be due to psychological reasons also, but other factors should be screened first. You need proper clinical examination and routine investigations. Investigations include routine hologram, random blood sugar, lipid profile, liver function test, renal function test, chest X-ray (PA view)ECG in all leads, TMT,ECHO. Further investigations can be done if needed. It is also important to exclude musculoskeletal causes of pain. Proper treatment depend upon findings. Take Care Chat Doctor. </s>

<s>[INST] Hi Dr. P.Koregol, I am Dick Lim age 67. Thank you for looking into my query. These result dated Apr 14; bracket was Jun 2013. My Cholesterol- LDL 64 (144). High HDL 156 (68) mg/dl n yet Total Cholesterol 240 (227) mg/dl. T 99 (75) mg/dl, Total Chol/HDL-Chol 1.5 (3.3); Ph 8.0 (7.5). Blood Monocytes 7% (6&); Lymphocytes 880 (882)/cmm. BP- 140/85 (below). Blood sugar fasting- 100 (86) Free T 0.96 (0.99) ng/dl. Bilirubin 1.7 (2.1) v mg/dl Exercise 2 to 4 times a week about an hr. each time. Kindly give whatever advises you can offer will be much appreciated. [/INST] Hello, All your blood investigation are in normal range except the lipids. Now for you, we will want total cholesterol under 200 and LDL cholesterol under 130 at least and preferably under 100. The good cholesterol HDL is normal and we shouldn't worry about the same. Low how would we do it? Atleast 45 mins of aerobic exercise Daily Cut on oils, red meat, egg yellow, fried and preserved food. May shift to healthy oils like olive, 2 serving of fish /per week. Supplement like omega 3 fatty acid 1-2 GMS a day, flax seed may work No medication required for any of your reports including lipids. After all lifestyle changes repeat a lipid profile after 3 months. Regards</s>

<s>[INST] i am suffering from ocassional breast pain(left 1) and nipple discharge accompanied with heaviness of the sae.i have been prescribed primosa capsules for 3 months. it s been a mon th and their is no change in the condition in fact i feel the dis charge is increasing. all the test,mammo, ultra sound have been done. most important: I am worried? please advice, moreover i am a lyposarcoma survivor ( cancer of the musce in right thigh ) and have been cured and operated on the same 9 years back. I am only concerned that it should not be return of the same. [/INST] Hi, Konikaji, Welcome to Chat Doctor, You have not mentioned the report of Mammography and ultrasound of breast. I advise to consult GAEC and get your breast thoroughly examined and get Mammography done. As there is h/o liposarcoma, you should be careful of not having any such pathology in the breast. Ok and bye.</s>

<s>[INST] Hi, may I ans doctor am 24 years, i dont have any problem healthwise but i just want to know about the disease called staphyloccocus and the ways it can be contacted, Thank you. [/INST] HI Thanks for posting your query. Staphylococcus is not a disease it is the name of bacteria that causes infections(disease). These bacterium are normally present in the skin and in the nose. So any breach in the skin or any inflammation in the nose these bacteria gains entry inside the body and causes Infection. The other possibility of contracting staphylococcus infection is by eating rotten food which would have been contaminated with these bacteria. Hope this information was useful to you. Any clarifications feel free to ask.</s>

<s>[INST] I m 56, female, a tad overweight (otherwise known as fat . lol), and my Dr. has diagnosed a lump between my stomach and the base of my rib cage, right hand side, as being a protuberant muscle. It hurts like crazy! And the pain shifts from side to side, even though the lump stays on the right hand side. Doesn t matter if I lie down and nothing much seems to help in terms of pain killers or even horse liniment. Have you any ideas as to what I can do to relieve the pain, please? Thankyou, Dr. Agarwal. Sorry, didn t realise it costs. Thankyou for your time and trouble. God bless. [/INST] Hi, Dear,Thanks for the query to Chat Doctor. I studied your problem in depth and I understood your concerns. Cause and plan of Treatment-In my opinion on the given data, you seem to have Epigastric Ventral Hernia with entrapment obstruction which is causing shifting pain from the adhesions of the chronic lump there. I would advise consulting ER Surgeon, who would treat it by Surgical Repair after study by USG scan.Don't guess more. I would advise ER Surgeon Consultation to avoid further complications with it. Hope this would resolve your issues. Act fast. So keep cool and Consult your ER Surgeon, if need be, who would treat it accordingly. So don't build up wrong concepts and create more psychic complications in you which would increase risks and costs to you, but just ask a query to Chat Doctor and be comfortable to resolve your health issues. Welcome for any more query in this regard to Chat Doctor. Write good reviews and Click thanks if you feel satisfied with my advice. Have a Good Day. Chat Doctor. N.</s>

<s>[INST] Hi, I m a 14 year old black girl . I used to have acne for 2 years but it has gone now but I have been left with hyperpigmentation on my cheeks, upper arms and upper back. I am currently using Lush products (only cleanser, toner and moisturiser) which have been working well. However, I would like a very effective solution that would hopefully solve my hyperpigmentation please. Thank you. [/INST] Hello thanks for using Chat Doctor . I would be pleased to answer your question For the hyperpigmentation, the best option is to get your skin exfoliated by a better method like a glycolic acid peel done every 15 days. A better option for you would be to visit a Dermatologist to avail of these peels. Alternative peel treatments like trichloroacetic acid are also very useful. I would suggest you get your skin examined by the dermatologist. For a home based treatment, Application of vitamin C based serum can be safe over long run. Thanks and take care.</s>

<s>[INST] I have been feeling like i need to physically throw up over the last week , my mouth is dry and salty and keeps filling up with a thick slimy spit. i need help urgently please i have tried ginger biscuits and water. what can i do? thanks. [/INST] Hi. Mouth Chat Doctor. A course of b complex supplements can help. If the problem persists you may need a few prescription medications.</s>

<s>[INST] I need to know what to expect in the near future with someone who has stage 4 liver cancer . Chemo and other traditional treatments didnt work and now are about to start some sort of experimental medication. They are in alot of pain and has lost approx 35 libs. said to be moving around a little better since chemo was stopped but now has a blood clot around where chemo was admitted. I am scared it is getting close to the end but not for sure as I dont know much about this horriable disease. Please help me understand. They have not discussed her chances with the family or her yet. Does that mean that the point of survival is mute ? how long could she have left ? [/INST] There is almost no hope to prolong life beyond a certain period of time.without complications we cans til hope for some changes in the outlook, but if already witChatDoctorplications, then very difficult to say the outcome.discuss the possibilities with the treating doctor who knows the patient the best, so he/she will be th the best person to discuss the outcomes of the disease.</s>

<s>[INST] I used nair for my bikini area and got some on my genitals as well.I have a stinging and burning sensation especially when i urinate.Uncomfortable feeling all around,sitting,walking.How and when will I have any relief? What can I do to help myself heal and what should i steer clear of (obviously razors and depilatories) till i heal?Thank you. [/INST] HI, thanks for using Chat Doctor It can take 2 to 3 days for the symptoms to decrease. You can use site baths to see if it helps. This would involve sitting in a site bath with warm (not hot) water for 10 to 15 minutes, 2 to 3 times daily. Normally table salt or Epsom salt is added to the water. The use of anti-inflammatory painkillers would also help e.g. naproxen, ibuprofen or Catalan hope this helps</s>

<s>[INST] My tailbone is starting to protrude with a knot on the end and it s very uncomfortable to lay on a flat surface. I m 5 6 at 108lbs now because I ve lost weight ...I am normally around 116lbs. My husband is concerned that I need to see a physician but I don t think it s necessary. Please advise ... Thank you! [/INST] Hello! Welcome to Ask a Doctor service! I understand your concern and would explain that your symptoms could be related to a cyst in this region. For this reason, I would recommend performing a physical exam and an X-ray of the sacral bone. A CT scan may be needed. Hope to have been helpful! Wishing all the best, </s>

<s>[INST] Embarrasing to ask...my rectum burns and itches really bad. For a year now it gets really sore after a movement. I wipe really hard, so I may have caused damage.?? I can wipe until clean and an hour later I burn and itch and wipe again and it s like I never wiped the first time.... [/INST] Hi, From history it seems that there might be having some local skin infection like dermatitis or yeast infection. Due to lack of personal local hygiene this problem might be there. Clean the part gently without giving more pressure and apply triple action cream. Take Cetirizine or Levi cetirizine for itching. In absence of itching there will be speedy healing. Take plenty of water. Avoid constipation. Clean local part with running tap water thoroughly. Ok and take care.</s>

<s>[INST] Hi..i m Itishree sarangi 28 years old.i have done my follicular study.but i think..i have some problem.my test started on 02/09/14 with 14th day.the size of follicle in right ovary and left ovary both are small size. Even no development for next test.but the endometrial thickness is increase slowly..22th day it is 9.1mm.plz suggest me...what can i do? [/INST] Hi, I think you should take some medicines like camphene for the growth of your follicles if they are not growing naturally. Track your follicles' growth by repeated ultrasound and when your follicles is more than 17 mm, take injection for rupturing the follicles. Be in contact with your husband for next 2 to 3 days. Take progesterone for next 2 weeks. Do a urine pregnancy test at home after that. You can try like that for 3 to 6 months. Hope I have answered your question. If you have any other query I will be happy to help. Regards Chat Doctor. </s>

<s>[INST] Hello, my son is 5 yrs and 6 month old. Every 2-3 days he develops balgam and coughs badly until he vomits and takes it out. Once he spits it out, he does not cough for next 2-3 days. We have observed this pattern for few months now and wanted to seek your expert advice. [/INST] Hi, thank you for choosing Chat Doctor. Kindly get your child examined when he has the cough to rule out any wheezing and also to check his sinuses to rule out any sinusitis as these lead to episodic cough. If he is fine in between cough episodes and his general checkup is normal no need to worry. Hope this has been helpful to you, kindly feel free to contact again for any queries. Kindly rate the answer if so. Take care. Chat Doctor. </s>

<s>[INST] Dear Sir, Request you to guide me for the following issues with my daughter:1) My daughter is 5 months and 20 days old.2) She had gone through a VSD closure on October 28, 2011.3) She discharged from the hospital with good health and after discharge she gained weight as well.4)Currently sometime she is suffering from bit uneasyness due to cold waether and start crying continuously. She is disgnosed by a doctor and the report was find.5) Doctor has advised for nebolize her for 3 to 4 times a day and levolin .3 mg syrup. Request you for your expert advice. Thanks & Regards, PremIndia [/INST] Hello ...after VSD closure gaining weight is good things ...occasionally child Chat Doctor. ...with viral infection commonly ...and doctor correctly prescribed u.... beside weigh gain u also need to follow with echo 6 months to yearly it will help us to know how is result of procedures and benefitting or not ...hope so You’re following like same ...take care</s>

<s>[INST] i have a good friend with multiple myeloma. he suddenly has developed a raspy voice. He has multiple hairline fractures in his spine and ribs and has become quite stooped and seems to have difficulty breathing. Is the raspy voice related to the condition of his spine [/INST] Hi, Thanks fir writing in. A raspy voice is due to stimulation of the recurrent laryngeal nerve which supplies the vocal cords. It is possible that your friend has a lowered immune status after taking treatment for multiple myeloma. This might cause him to have infection in the throat which is causing irritation to the recurrent laryngeal nerve. Any infection or condition in the throat might cause the raspy voice. It is suggested that he consults the ENT specialist immediately and has a clinical examination of his throat done. This will show any inflammatory changes in the region and whether it requires treatment. Please tell him to do throat gargle with warm water twice daily to soothe the throat. The raspy voice is not related to his spine but might have an indirect association to his treatment which he is getting right now. Please do not worry.</s>

<s>[INST] I am 34 and I have been suffering with swollen legs and ankles , to touch the skin feels like i am being stabbed with glass the skin isnt broken and its not a dvt as i have had tests for that i have also had xrays and there is no breaks, they are really itchy and very sore [/INST] Hi, there are two chances for this1-RHEUMATOID ARTHRITIS 2-GOUTY Arthritis way consult one rheumatologist or or tho doctor and do the best thing early thanking [email protected]</s>

<s>[INST] Hi DoctorI have a doubt, just today i got prolactin test done for my wife, report says prolactin is @29.17ng/ml, can you please let me know the treatment get it down to normal stage. We are trying for children from past 2 yrs, is this a prob for not conceiving? if prolactin is normal conceiving is possible? [/INST] Tab Caroline may help to bring prolactin level downInitial dose: 0.25 mg orally twice a week. Dosage may be increased by 0.25 mg twice a week. Maximum dose: 1 mg orally twice a week (according to patient serum prolactin level). Regards Chat Doctor. </s>

<s>[INST] im chris im 23 and my girlfriend is emma 22 we are a white couple.I have recently persuaded my girlfriend to agree to meet a few other men so i can watch her have sex with them. These men are all black men and i have asked emma my girlfriend to let them have sex with her unprotected. When this happens emma will take 3 black mans sperms in her, she is currently on the pill at the moment , will the pill still work if 3 black men cum in her?? [/INST] Welcome to Chat Doctor, The contraceptive pills will protect her from being pregnant. But at the same time she is not protected against sexually transmitted diseases. So I recommend you to stop such activities as it may cause illness to her. Use a condom next time during sex. Hope that answers your question.</s>

<s>[INST] my last LMP is may 6th 2012, yesterday i took Ultra sound pelvis scan & the observation is no seen of any gestasional sac then oru physican sussgest to take tab-Mensovit for getting periods,,,,,,,, i am very scarded to tak the drug mam it is not harful to our body mam [/INST] Hi, Mennonite plus is an ayurvedic preparation and hence its efficacy in initiating periods cannot be confirmed. Many effective Chat Doctor. Kindly visit your gynecologist for further management. Hope I have answered your query. Let me know if I can assist you further.</s>

<s>[INST] HI, my mother is 56 years old and has been having darkly pigmented patches on both the cheeks for almost 5 years now. is it safe to use candid B cream on the face or any other medication for it? have tried alot of ointments but none have been effective. [/INST] Hello, i would strongly recommend you not use Candid B cream for the dark pigmentation on your mothers cheek. Candid B cream is an antifungal cream with steroid. This cream is used only in specific dermatological conditions as prescribed a qualified physician. There are a variety of skin disorders causing dark pigmentation. The commonest cause of dark pigmentation on cheeks in an elderly lady is a condition called Plasma. The cause of plasma is complex. There is a genetic predisposition to plasma, with at least one-third of patients reporting other family members to be affected. In most people plasma is a chronic disorder. Sun exposure, pregnancy, hormonal changes, photo-toxic reaction to Scented or deodorant soaps, toiletries and cosmetics or medications are the commonest triggering factors of Plasma. There are different modalities of treatment for Plasma and I would recommend you to consult a qualified Dermatologist for an expert opinion regarding your mothers skin condition and treatment.</s>

<s>[INST] Hi iam 34years. We are trying for a baby for the past 1 year... my periods were regular and my doctor said my ovulation is normal. I had been taking folic acid supplements only. I did foliicular study for about 5 months ina row and everything was normal. Recently my last cycle ended up being an anovulatory cycle. I got my regular periods without any delay. My bleeding was also normal. My husbands reports are normal too. All mu harmonal blood tests were normal, the same month i had anovulation. Is thus possible. What is happening to me? [/INST] Hi I think you can take some medicines like camphene for inducing ovulation. Track your follicles' growth by repeated ultrasound and when follicle is more than 17 to 18 mm, take injection for rupture of follicles. Be in contact with your husband every 2 to 3 days after your periods stop. Take progesterone for next 2 weeks after rupture is confirmed on ultrasound. Do a urine pregnancy test after that. You can try like that for 3 to 6 cycles.</s>

<s>[INST] I had been experiencing lower back pain for over a week. Initially, I though it to be a muscle strain/pull. I have alternated ice/heat/stretching (after icing the first two days). The pain has now progress to my rip hip and pelvic area and even to higher portions of my back. I am also feeling nausea, lightheaded ness, and numbing/tickling sensations in my lower legs. Please advise. [/INST] Well...the lower back pain...it can be arisen from different structures at the back from skin to the bones depends on age and other factors. The being pain can be settled by taking painkillers and physiotherapy. In elderly patients this pain could range from osteoarthritis to metasis. But pain in young patient not improving with medications...then it is alarming... But you have alarming symptoms.your pain is radiating to the pelvic area .the lesion looks like to be in the L5,S1 disc... You better do a CT scan of lumbosacral area and consult a neurosurgeon.</s>

<s>[INST] dear doctor I have marraid past 4year but i dont have any child and my doctor sugest me and my wife as well to take one month evion 400 can you sugest me it is any benifit...... [/INST] thank you for the inquiry.have you undergone any medical checkups. please share me the results</s>

<s>[INST] Hi Dr. Good afternoon,I am a survivor of Squmousa cell carcinoma of the tongue two years back. Recently there are two neck lumps visible and MRI scans confirms the enlargements. Is it a sign of metastates??? What should I do further to confirm it? [/INST] Welcome to Chat Doctor .1. Possibilities of metastases can not be ruled out (in your case) without an FNAC - fine needle aspiration cytology of an enlarged lymph nodes.2. Generally lymph nodal enlargement is seen after local or systemic, infection or inflammatory cause. And ease off after treatment.3. You have done MRI - it would have given you the status of the old treated tongue malignancy. A computer tomography with contrast will help to see the status of previous malignancy.4. Get an ultrasound abdomen done - to see the status of liver and abdominal lymph nodal enlargement.5. Get an FNAC of lymph node for confirmation and treatment to commence. Good luck. Hope it helps you. Wish you a good health. Anything to ask ? Do not hesitate. Thank you.</s>

<s>[INST] I am 64 years of age but still interested mating wife.But if a gap of one week persists for mating, I occasionally feel early ejaculation. If I can control this moment, I continue for a good long period. Because of this unsure intercourse, I feel of the fear that I may not satisfy my partner .Can you mention the treatment for this type of early ejaculation .I am free from any ailments.Frequently I ride Stationary cycling. Thank you very much,,, [/INST] Dear sir, thank you for writing in. Welcome to the forum. You can try the squeeze technique, start stop technique or use an anesthetic condom. A number of medications such as Dallas, flu nil or next are also useful. Please remember that while using the squeeze or start stop technique, the key thing is to initiate action when a mild sense of ejaculating occurs but well before you sense a loss of control. It is better to err towards the former. Thanks.</s>

<s>[INST] My umbilical hernia feels like it is getting worse. I cant see a surgeon until tuesday .my lower back muscles Are very strained and seems to be related. I dont have any classic symptoms like it is strangulating but my abdomen is extremely bloated and the actual buldge of the hernia seems larger than yesterday. [/INST] Hello, For now, you can do icing for your hernia and hot water fermentation for the lower back to relieve the symptoms. Post this take good bed rest and repeat the procedure for 3-4 times a day. Only if you are diabetic then icing is contraindicated. Post meeting the surgeon please do let me know what are the next calls considered by the surgeon. In my clinical practice of over 12 years, most umbilical hernia issue is resolved by exercise. Hope I have answered your query. Let me know if I can assist you further. Jay In Chat Doctor. </s>

<s>[INST] Doctor . My wife is currently 30 and is on phenobarb for treatment of epilepsy. She has been taking the drug for past 27 years recently we have decided to get a baby and hence approached a doctor who suggested us to take keppra to avoid birth defects. We currently stopped phenobarb and are on keppra for the last 1 week. Please advice if we can proceed to get a baby in 6 months by reducing the drug. [/INST] Hi, as the Chat Doctor. There is no risk in conceiving. You can try every 2 to 3 days after periods stop. Hope I have answered your question. If you have any other query I will be happy to help. Regards </s>

<s>[INST] Hi Doctor, I have some problem relating to my behavior/ personality or I don t know exactly what you call it. I cant be able to concentrate on my work as lot of destruction keeps on hitting my mind away from the work. I discussed about it with my friend earlier through online chat, she asked to consult a female psychiatrist as my problem is related to females. So please advice me a doctor to look after my problem and it shouldn t be expensive as I don t possess lot of money. [/INST] Degree understand your concerns went through your details. I suggest you not to worry much. You have not mentioned your age. Concentration problems do arise to people at every stage, but it is more present with young adults. You are supposed to refer to concentration and attention as two. Attention span for any adult is maximum 30 minutes. Sometimes, a person can be attentive to an interesting thing for more than 30 minutes, such as movies or games. Concentration is attention plus understanding. For this too, span of below 30 minutes. If you are able to make your studies interesting and based on variable principle, your concentration level can be increased. Concentration comes only when you are interested in what you do. So please be passionate towards what you are doing or do only those things which you are interested in. It is also possible to improve your concentration level with the help of yoga, meditation and breathing exercises. Psychotherapy techniques should suit your requirement. If you require more of my help in this aspect, Please post a direct question to me in this URL. http://goo.gl/aYW2pR. Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques. Hope this answers your query. Available for further clarifications. Good luck.</s>

<s>[INST] ASPIRATE IS THICK MUCOID METERIAL AND SMEAR CONSIST OF FIW ROUNDED OF COLUMNAR EPITHELIAL CELLS HAVEABUNDANT CYTOPLASM &UNIFORM NCULEI THERE ARE SOME INFLAMMATORY CELLS MAINLY POLYMORPHS AND LYMPHOCYTES ALSO SEEN NO ALYPACAL CALL SEEN. IMPRESSION FINDINDS ARE SUGGESTIVE OF THYROGLOSSAL CYST , [/INST] Hi, there would be small swelling or lump in the neck usually in the midline. It can also move while you swallow as well as when you Chat Doctor. These signs will point towards a Hypoglossal cyst, usually found in child</s>

<s>[INST] Hello Doctor,I am 7 weeks pregnant although when did an u/s scan it came out as 5-6 weeks of pregnancy.(My periods are normal 27-28 days cycle). There was no fetal pole and heartbeat but a gestational , yolk sac is seen. Doctor has advised scan after 10 days and said this will be the max waiting time for a fetal heartbeat. I am advised to take hormonal tablets (Conest). I am very much worried and really hoping the best for my baby. Can you please tell me how much possibility is there for a fetal heartbeat and fetaql pole after 10 days. Thanks in advance. [/INST] Hallow Dear, Usually by 6 weeks or so the fetal pole and fetal cardiac activity is detectable by ultrasound. If by 7 weeks, it is undetectable, there are following possibilities:1. The ovulation and conception might have occurred late in the menstrual cycle, which otherwise happens 14 days before the next menstrual period.2. There could be mistake in calculating the duration of pregnancy.3. The pregnancy could be without embryo (baby). This is known as blighted ovum. In such case, the ultrasonography image shows corrugated margins of the sac. If the margins of the sac are well-rounded, in order to exclude the first two causes, it is a good option to repeat the scan after a week to 10 days. If still the sac is empty, then the diagnosis of blighted ovum is confirmed. However, if the edges are corrugated, it is blighted ovum. Pregnancies with blighted ovum do not grow. If such pregnancy does not abort spontaneously, termination is the requirement. I hope this helps you. </s>

<s>[INST] Theres a creaking/squeaking noise located in my chest/throat every so often when I take a deep breath, my chest hurts. I also have had a stuffy nose for weeks but that has cleared up recently. My ears block up, and my chest hurts. I have no way of taking my temperature as I cannot find my thermometer. [/INST] Hello rearward welcome to Chat Doctor.come have evaluated your query thoroughly.* This is in relation with lower respiratory infection, blockage of bronchi or alveoli through inflammatory response to bacteria or virus. Hope this clears your doubt . Wishing you fine recovery. Welcome for any further assistance. Regards dear take care.</s>

<s>[INST] Hi, i just received a message from my officemate, the ultrasound result is "Within the enlarged uterusis a single fetus in cephalic presentation at the time of examination. Real time scans reveal absence of fetal movements and cardiac activity" she said she will be operated this afternoon and the baby is gone. 3 days ago she told us she felt the movement of her baby. How come that her baby is gone. [/INST] Sometimes due to genetic disorders baby loss is there...sometimes due to maternal thyroid levels are high prey loss can occur</s>

<s>[INST] my son is 10,51 inches, and 79 pounds and had a fever Sunday morning of 103.3 with fever reducer it went down to normal temp. It then came back around 6 in the pm. and took a second treatment of fever reducer and it went down easily.About 10pm i took his temp and it went down to 96.3 I have been keeping an eye on him and he has been sleeping, sweaty and his body cold.I currently took his temp and it is down to 93.8. His temp has never been low before. I have 2 blakets on him to try and get him warm. He has been on antibiotics since friday for double ear infection and has been complaining about his trout hurting, stomach hurting,a bad cough, he has mouth sores and cant eat. What do I do? what could it be? whe do i worry about hte low temp? [/INST] Thanks to ChatDoctorI can understand your concern don't worry, fever in most of viral infections have sudden rise and fall below normal once we have taken medicine if there are no chills and rigors don't worry, it won't cause any trouble anyway ear infection will be controlled by antibiotics to prevent secondary infection just undergo some investigations like CBP. TIDAL, FEVER PROFILE CHEST X RAY FEVER NOT SUBSIDE Let him continue antibiotic till reports comes and antipyretic like paracetamol along with above Chat Doctor. Gentle doing mouthwash will help to relieve soreness of mouth . Ok plenty of liquids orally is better than solids low temperature generally up to certain extent nothing will harm the body. Clean the ear with chosen buds if there is discharge , keep it clean he will be normal shortly .ok</s>

<s>[INST] hi there after being bullied at work some 5 months agao by two of my colleagues I was told last week that I would I would be being moved out 2 days later I felt dizzy and have been told by my gp that I have vertico could this be work related Regards Alan [/INST] ! After read your use question carefully I can understand that you have been facing a lot of issues at work lately. As you have mentioned that you developed vertigo after all these problems s at work, it is possible that stress is behind all of them. We see such cases daily, when a person is under lot of stress, which he feels that he is trying to handle, but unconsciously, the mind is troubled and person develops variety of symptoms. I think you should listen to your doctor, as your vitals and basic test if done, are within normal limits. I have seen such patients responding greatly to combination of cinnarazine and dimethyl Chat Doctor. Day) for some days for vertigo. Plus, try to get a good walk daily, and eat healthy. If vertigo still persist, you may get an X-Ray neck to rule out cervical. If along with vertigo, you have sadness or anxiety, please meet a psychiatrist for complete treatment. Hope the reply helps you in getting well soon take care, and feel free to ask more questions</s>

<s>[INST] I was first diagnosed with 1 nodule on half of my thyroid (I had left side removed /tumor in thyroid had to remove to do biopsy in 1989) then it became 2 and now 4. Three are solid and 1 with fluid. Had biopsy done early in April of this year and they were benign. My question and concern is can they eventually become cancer if they are not taken care of? [/INST] Benign nodules of the thyroid if left untreated can become malignant over a long period of time. Roughly 10% nodules become malignant over 20 years. The features of they're turning malignant are sudden increase in size, pain, appearance of other nodules outside the thyroid, change in voice, difficulty in breathing or swallowing. Any of these changes should prompt you to consider removal of the remaining thyroid.</s>

<s>[INST] hi. my name is laila, and my husband and i made love about 2 1/2 weeks ago. its been almost 4 weeks since my last period. i have poly cystic ovarian syndrome, but i have taken hormones in the past that has allowed me to have a normal cycle every 3-4 weeks. i am getting a few cramps here and there, but i dont have any symptoms of a pregnancy. i dont know if my cramps are from an upcoming cycle, or if its the beginning of a pregnancy, a little help please ? [/INST] Dear Leila, You are indeed having a peculiar situation. Usually, PCs (Polycystic ovarian syn Chat Doctor. However, since you were on the treatment, it is likely that you might have ovulated and have become pregnant. Missing a period, which is the first cardinal symptom of pregnancy also may misguide in your case. In PCs also, there is delay in menses, many a time for few months also. I would recommend you to get the confirmation of your status of pregnancy by Chat Doctor test. At this stage, Beta Chat Doctor test will be quite useful to you. This is a very specific and sensitive test and gives reliable results within 2-3 days of missed period, or even before that. I hope this will solve your dilemma.</s>

<s>[INST] I have an itchy sore on my back that scabs over very quickly (4-6 hours) and the scab is very thick and feels like wood splinters. I m always tearing it off when I scratch the itch. There is a hard lump way under the skin. I ve had this for over six months now. what might it be? [/INST] Hi.it is best if you consult with a doctor, preferably a general surgeon, for medical and physical examination. Based from your description, it could be a cyst (a sebaceous or a gelatinous type). These lesions can occur anywhere in the body and have the tendency to recur. Medical (proper antibiotic regimen) and surgical (excision of the lesion) management will be directed accordingly. Hope this helps. Good day!!~ Chat Doctor. </s>

<s>[INST] My son who is 8 years old has constant stomach ached from last Christmas onwards. We think its acidity because it is usually when he does not eat for more than 2 hours. But its so often we are a bit worried. it seems like cramps. We give him carmiscide. [/INST] Hi, There is no problem giving him parricide for abdominal colic. But as he is having this problem since long underlying cause is to be found out, like Hi infection, bacterial or amoebic or worm infestation. Consult your doctor and get examined.Meanwhile, you can continue with parricide as and when required. Ok and take care.</s>

<s>[INST] I had what I thought was an ingrown hair in my armpit pop up. After a few days it grew the size of a golf ball and continued to get bigger. It was so painful I couldn t move at all but put my arm in bent position curled against me. After going to the doctor she said it was a MRSA infection and opened it up and drained it. (I received the lab results back stating it was MRSA) Now, two weeks later, the bump under my arm is gone but I have something string like enabling me from fulling extending my arm above my head. You can feel the strings from my armpit past my elbow. I went back to the doctor and saw one of my doctors associates and he said I have something called Sporotrichosis and will need to be on an antibiotic for a couple of months. Does this sound right? I ve looked up Sporotrichosis and my arm doesn t look like that but I found AWS (Axillary Web Syndrome) and my arm does kind of look like that but I did NOT just have any breast cancer surgery. [/INST] Hi.Thanks for your query. Noted the history of enlargement of axillary lymph nodes with strings radiating from elbow to the maxilla like a web, axillary web syn Chat Doctor. With the history you have provided, this looks to be lymphangitis causing the strings under the skin from the elbow to the maxilla which has now enlarged lymph nodes. I would advise you the following in such a case as definite cause may not always be found and hence also called as Idiopathic. Blood smears to be prepared at midnight and examined for elephantiasis that is filariasis. Blood to be tested for CBC and other routine reports like sugar, kidney and liver functions. A course of an antibiotic and Albendazole to be started asap. A 3-week course of Genocide forte that is diethylcarbamazine helps. Give rest to the affected arm. Plenty of oral fluids orally to combat deny</s>

<s>[INST] How to treat hepatitis B surface ab and what the best way to prevent that? Does hepatitis surface past infection or become worst? How to healing or treat hepatitis surface B core ab? What kind med need to take? Need to see a doctor with treatment or can self treatment? Please explain to me all the reasons and all the information about the hepatitis B surface ab and hepatitis surface B core ab. [/INST] Hi far. It is obvious that you need information. You cannot treat antibodies. Antibodies are products of our immune system which helps us to fight against viruses and sectarian. You need to treat hepatitis. These antibodies just can tell us is there any reaction on infection in our organism. Soyou have obviously been infected in your life because you have these antibodies. Question is your infection active and symptomatic. To know this you must find antigens levels(Ag) and viral RNA polymerase test. If you have HBS Ag and HBC Ag positive then you have infection which persist and can cause liver damage and should be treated. If not it means that you passed through infection and there is no risk for liver damage. Hope i ve been helpful.</s>

<s>[INST] Hello Doctor, My name is Mrinal Singh. I am pregnant and my pregnancy is going on 3rd month. I have a little quiry to you, actually I want to know that is it safe to take zincovit tablet in pregnancy or any other side effect to use. I am little bit confuse. Please guide me. I can take this medicine in this period. Thanks [/INST] Hello, In my opinion, it's not safe to take the Chat Doctor. It has zinc and potassium, which is not very safe to take in pregnancy withholding in it will be better. Hope I have answered your query. Let me know if I can assist you further.</s>

<s>[INST] About 6 months ago I developed fatigue and wheezing. I am 67 with a history of cardiac problems. I was born with Fallot s Tetralogy which was corrected in 1964 in Bristol. It was very successful and I have had nearly 50 years of almost complete health, firstly as a teacher, and then as a vicar. I retired 2 years ago sadly because I had devloped an alcohol problem so I now live in care and haven t drunk since last August. When the wheezing began I automatically assumed it was due to a worsening of the residual faults from my Fallot s correction. I have lived with a small VSD, pulmonary stenosis and some atrial regurge. But having spent a week in hospital having echo tests , e.c.g, x-ray etc. the team failed to find any deterioration that would cause the things I am experiencing. A few weeks ago , however, I became aware of a hard lump under my right nipple. Not really painful but a bit sore. So I wonder if it s possible that I might have Male Breast cancer (however rare) and whether the wheeze, tightness of chest and breathlessness might be due to that. I don t want to bother my GP unnecessarily but on the other hand if it is a carcinogenic lump I would like to seek any treatment that might be available to me. Thank you. Rev. Robert Pitcher. [/INST] His would advise you to do a PET scan. If any space occupying lesion is found then biopsy has to be done to rule out cancer.</s>

<s>[INST] Hello Sir/mam, I am K.Mandal (Male 26) from kolkatta have been diagnosed as OCD with venerophobia of (HIV) and other vernal dieases (PAST).and now having PANICK DISORDER and phobia of going out side alone. (present) by my psychratist. He prescribed me Paxidep cr 37.5 daily morning after breakfast for 5 years.and zapiz 0.5 for sos during panick attack. So I want to know will it be safe for me to take paxidep for such a long duration...as this drug show some side effects like sextual dysfunction of achiving orgasim. and some cramping pain in lower abdomin at afternoon after having lunch. [/INST] HelloPaxidep is paroxetine and it is a SSRI Chat Doctor. It is very effective in anxiety disorders like OCD as well as in panic disorder. It is safe to use this </s>

<s>[INST] Hello I am writing regarding my 4 1/2 year old grandson who was diagnozed with high blood pressure at 6 months and is on medication. He gets extremely red patches all over his body when he is upset,or excited about something. Ears, neck, cheeks, chest legs get red and are warm to the touch. We have told his Drs and they are unable to explain it. Do you some thoughts as to why this occurs. It dissapears when he calms down. Could it be something life threatning. [/INST] Hey, A child of this age can have high BP with certain conditions and syn Chat Doctor. Firstly you have to rule out any condition of aorta like coaptation of aorta in which aorta is stenoses. You have to rule out abnormalities of kidney. So get all these tests done. He may have a serious underlying condition.</s>

<s>[INST] Hello,I just went to the dentist for a crown and not sure what happen, but when the doctor was putting the anesthesia I felt a sharp pain in my eye, the same side he was working. When he was done I felt my cheek was different, and yes, I have a big lump. Should I be worried it could be an infection? Is there something I can do to relief the swollen?Thanks for you help! [/INST] Hello and welcome. Thanks for sharing your concern. The lump that you are experiencing now, could be due to locally deposition of local anesthesia. It should diffuse within a few hours or so. Then the lump should go away. It is not an infection. Regarding sharp pain in the eye, it appears unrelated. But if you find persisting symptoms in relation to eye then please revisit your dentist.Also, please mention in which jaw the crown was placed upper or lower?so that I can suggest better in this regard. Hope it helps. Thanks. Take care.</s>

<s>[INST] sir,i want to know about hbsag levels i tested first time on 22nd december 2009 and the result was hbsag ............reactive (250)test performed by ecliathen on 29th march 2010 and the result was hbsag...............reactive (5471)then on 26th april 2010 and the result was hbsag........... reactive(569.2)then on 12th may 2010 and the result washbsag .......... reactive (125)then on 30th may 2010hbsag ......... reactive (26.27)then on 10th june 2010hbsag ......... reactive (8.16)and then recently 23th june 2010 and the result was hbsag ........... reactive (4.29) sir, i want to know that am i going to resolve the infection or am i now a chronic hbv patient, and is this normal the slow decline in hbsag levels in the end. with regards MUHAMMAD IBRAHIM KHAN [/INST] Hi.thanks for posting query. HepB can not be eradicated completely in patients infected with it. However, complications can be prevented with proper care and treatment. Treatment is advised if AST and ALT are > URN and HBV DNA count on PCR is very high. Liver enzymes and Bag status and HBV DNA PCR maybe done regularly every 6 to 12 months, Visit hepatologist for proper interpretation of results. Hope to answer concern regards Chat Doctor. </s>

<s>[INST] Hi my name is Mary my doctor had me on Descartes for about 5 years for hydrogenated disc in my neck and back. I noticed this started up when I started taking them but they kept not finding anything by the time I could get an app. They took them off the market because of them doing something to your heart. I have a heart monitor on now they found atreal run and atreal couplet. What is it and is it dangerous and what is the cure for it [/INST] Hello Mary, I have gone through your details. Basically atrial runs and couplets are benign unless associated with structural heart disease.Therefore, I suggest you to get your Doppler echocardiography done. That will rule out any serious defect in heart. I request you to avoid smoking and excess coffee. My best wishes. Chat Doctor. </s>

<s>[INST] When I work out it starts to feel like im getting needles pushed into the back of my brain. its sharpe and quick continuous pain. My chest ( not as often as my head) starts to feel like someones sitting on it. I can still breathe okay through all of this. the more often I work out the long the needles in my brain lasts and the worse it gets. I have just recently started working out 4-5 times a week. [/INST] Hi, I am Chat Doctor. I have read your question and understand your concerns. Let me try to help you have described signs of Ischemia When you exercise, too much blood is shunted out to the muscles so that the other parts gets less blood supply and hence you get the symptoms you have mentioned The solution would be to reduce the Weights / Counts of your exercise for few days and then gradually increase them This is easily manageable :) Hope you found the answer helpful. If you need any clarification / have doubts / have additional questions / have follow-up questions, then please do not hesitate in asking again. I will be happy to answer your questions. Let me know if I can assist you further. Take care.</s>

<s>[INST] I was also told that I have a smaller-than-normal gal bladder for my age, weight and height, after I had fasted and had an abdominal sonogram. The reason for getting it was due to severe pain in my abdomin, and various other issues. Do you know what caused this smaller-than-normal gal bladder? [/INST] Hi welcome to the Chat Doctor Small gall bladder can be from fibrosis secondary to chronic inflammation of gall bladder... Gall stone also can lead chronic inflammation and so small gall bladder Investigate with USG scan and let me know you your USG report for giving more comment If needed HIDE scan can be done for that Take care Hope your concern solved</s>

<s>[INST] I have a sizable hard lump by my right collarbone close to the inside base of my neck. I ve been getting headaches frequently and have difficulty and pain in my neck and shoulder when I sleep on my right side or tilt my head to the right. My neck also feels stiff and it feel like something is pressing against the inside of my throat near the lump. What could this be? [/INST] Welcome. I have gone through your query. It is difficult to comment on it without examination, so I would either suggest you to see doctor for examination and for exact diagnosis or upload the pictures here, I'll go through them, and provide you with specific advice. Lump might be folliculitis but need to examined to confirm. Hope this helps. Take care</s>

<s>[INST] Hi... I am 26 years old, 80Kg in weight, 6 feet tall. I do jogging thrice in a week. In last one year, many Lipoma formed in my body especially in hand and stomach area. Few of them are close to chest rib bones which creates pain sometimes during my run and sleep. Is there any medication to get rid of these Lipoma or surgery is the only way? If so what kind of surgey I should undergo? Please advise. Thanks. [/INST] Hello have read your query. No need to worry about lipoma. If this give pain then only remove. Yes surgery is the only treatment. Laser may sometimes help.don't operate till very painful. I hope I have answered your questions. If you have further questions please feel free to contact us. I will be happy to answer. Take care.</s>

<s>[INST] Good evening. I have recently had a challenge test to sulfa and was extremely allergic to it after 4 hours. I have not had my follow up appt with my allergist yet but scheduled in two weeks. If I am allergic to sulfa, does that mean I must be careful with products containing sulfite, sulfate and sulfur? I know that I did use bactrim (which has the sulfa) before having the challenge test and that reaction is what prompted the challenge. How about Desonide cream which contains aluminum sulfate? Thank you in advance for responding to my question. Barbara [/INST] The ChatDoctor. </s>

<s>[INST] I have a raised region on left side just below ribs. I went to the doctor he felt my abdominal region said there was nothing to worry about. However I still have this lump or swollen area. It s not painful but sometimes uncomfortable I have to lift my left shoulder up. I m thinking it could be my posture but this wouldn t cause swelling. It s slightly noticeable what could it be?? [/INST] Hi, as mentioned by you, about the swollen or lump area, and also examined by doctor where he said It's nothing to worry.of course I agree to you that how come something comes up like this and is painful. And also how come the swelling is persisting. What I would suggest is to undergo an x-ray and check as it may reveal something with it. Maybe a fluid accumulation. Also, later on an MRI will guide to see what soft tissues are involved in that area leading to swelling. Until we get a picture of the soft tissue abnormality it will be really tough for anyone to examine and comment. As diagnostic holds the strong ground for assistance. I wish you get an MRI done, so we can come to know what sort of soft tissue is involved a muscular or a lung tissue. With the grace of God I wish you a speedy recoveryregardsJay In Chat Doctor. </s>

<s>[INST] Last year I was operated for cholecystectomy the year after I again had that severe abdomen pain and was hospitalised for 15 days in ICU , diagnoised with CBD sludge thereafter on udiliv. After 3 month I again had blood test and amylase was quoted 407.3 after 3 days again the same test was taken and amylase reading was 242.9 and lipase 37 . Doctor has advised for ERCP. My question is if the sludge is still there does not udiliv help in flushing it out, if not for what purpose has it been recommended to me. Whether ERCP is the only cure? [/INST] Hi ! Good afternoon. I am Chat Doctor answering your query. Udiliv is a Chat Doctor. However, this is not a 100% cure for it. Even though the pancreatic enzymes have come out to be within the normal range or of decreasing level, there possibly is a suspicion of pancreatitis by your treating physician, and also to know the complete anatomy of biliary tree along with the pancreatic duct, an ERCP is advised. This would be a near confirmatory investigation to rule out the biliary tree and the pancreatic system as the cause of your abdominal pain. ERCP could also be of therapeutic nature if the sludge/calculi in any of the biliary tree is endoscopic-ally removed. Till then, you could go for some anti-spasmodic and a proton pump inhibitor </s>

<s>[INST] I had gone through Radiotherapy after surgery of tongue for squamous cell carcinoma about 20 months ago, Now I my TSH level has gone up and it is 7.69, I have been advised Eltroxin 50 . OD. Another doctor has advised Thyronorm 50 OD.. Could you guide me which is a better medicine. YYYY@YYYY [/INST] You have hypothyroidism secondary to radiation therapy to neck. It requires replacement of thyroid hormones. Both Elton and Thermoform contain levothyroxine. Elton is more expensive than thermoform. If you do not have affordability issues I would suggest Elton as I have found it to be very effective in my patients and is well known to be a quality brand.</s>

<s>[INST] hello sir,i m 27 years old single male.i used to masturbate very frequently n the frequency was nearly 4 to 5 days in a week.now i feel the erection is not that much hard as it was before n even suffering PME. i even afraid regarding less sperm count n cum (sperm) is also not thick.please suggest me as what step should i take.Plz help.Regards... [/INST] Dear, We understand your concerns went through your details. Let me assure you, masturbation is not unhealthy. Masturbation is normal and natural. Frequency of 4 or 5 times a week masturbation is pretty normal and not in excess. Therefore, masturbation is not the reason for your present problem. I think you are obsessing with your sexual ability and sexual organ. Unless you are actually in sexual intercourse, you cannot judge your hardness. Secondly, when you try to test your hardness, the hardness comes down, because at that moment, you are diverting from sexual thoughts. The reason for your present problem is simply psycho-logic and never organic. I suggest you to consult a psychologist for sexual counseling. 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 detail possible. Hope this answers your query. Further clarifications are welcome. Good luck. Happy New Year. Take care.</s>

<s>[INST] Dear Doctor, Last few days (4/5 days) I feel head dizzy, I could not think anything properly, Basically I feel, my back side of head has been zam. My blood pressure is normal. Age 34 yrs, Male and I was passing a serious brain stress in 20 days due to illness and death of my mother. Please suggest me, what can i do. [/INST] Hello, Thanks for choosing Chat Doctor for posting your query. I have gone through your question in detail and I can understand what you are going through. These could be a manifestation of depression. You will need some benzodiazepine and SSRI medications like Escitalopram or mirtazapine to help with your problems. Some psychotherapy will also help. Hope I am able to answer your concerns. If you have any further query, I would be glad to help you. In future if you wish to contact me directly, you can use the below-mentioned link:bit.ly/ Chat Doctor. </s>

<s>[INST] My wife age 38 is HBV positive with acute measure and Dr. has told that she is not in carrier stage and does not need any treatment. The quantitive test result somewhere 625. Can this HBV get removed completel, does this quantity increases in future, what could be the effect on liver functioning in future. Please explain. [/INST] Thank you for posting query. Carrier state means that your wife is infected with Herb (Bag positive) but the replicating antigen of virus maybe negative and the viral load may NOT be high enough requiring treatment. Virus is in "dormant" phase. It is possible that the virus remains in dormant phase throughout and causes no harm to liver. Only one fourth of patients infected with Herb virus develop liver cirrhosis. Therefore, one cannot be sure about her status. The viral load should be monitored, and she needs to repeat test every 6 month or at least once a year. You should also inform your treating doctor if you want to plan a baby. There is NO permanent treatment for Herb virus. However, all relatives of your wife including you need to be vaccinated against Herb (if not done yet).wish her good health. Further queries are welcomed. Health professionals aim to diagnose properly and manage patients according to their limited knowledge. Cure is blessed by the ONE who Created us, whose power and knowledge is unlimited .wish you good health. Regards, Chat Doctor. </s>

<s>[INST] I m a teenager who has entomophobia and I ve had it ever since I was a kid. I don t exactly know the reason as to why I m so terrified of insects. People around me tend to get annoyed by me sometimes because whenever I see a cockroach or any insect nearby, I get so scared that sometimes I cry when I can t contain it anymore. They tell me to get over it and they say I m just overreacting but no, they don t know how I feel. I feel so frightened around them. I don t want to undergo any therapies, though. What should I do about it? [/INST] HiT hanks for using Chat Doctor Entomophobia is a specific phobia and in treatment, there are two options. Once you can take antidepressant like paroxetine after psychiatrist consultation and second exposure therapy with help of psychologist. With both, you would get better and earlier effect. Rest, it's your choice. Thanks</s>

<s>[INST] I have been having a constant pain in my left upper abdomen area under my ribs and its a dull achey pain but when I am under stress or get upset and or eat spicy foods it makes my pain go from a dull achey constant pain to a sharp stabbing pain and gets so severe It hurts to move. What can it be? [/INST] HI. The pain in the left upper qua Chat Doctor. You need to undergo the following tests. CT scan of the whole abdomen. Upper GI Endoscopy. Relevant blood, urine and stool tests. Colonoscopy if required. The treatment t is :To stop the hot and spicy food, aerated </s>

<s>[INST] my name is khalid my age is 38 and hight is 5-6 my wt is 80 kg.i masterbate for 20 years untill my marriage 6 years back.but after marriage i felt erectile dysfunction. i was unable to satisfy my wife though have a child.my penis sie also remined smwhat small and have a little bend.veins of my penis also now apparent when ever in minopr erection. i have strong feelings of sex but when ever tried to penetrate my penis feels the hotness of vagina andprematurely ejaculates within seconds.i am toomuch worried for this please guide me. [/INST] Hi.welcome to Chat Doctor.I understand your problem.my opinion is that,1.don't masturbate more than twice in a week.2.avoid stress.3.sleep for about 8 hours in a day.4.take nutritious foods.5.Lincoln gel application on the penis before sex may give good results without any side effects. Thank you. Hope my answer will help you.</s>

<s>[INST] hi ... hubby and me are trying for baby . Whenever we have sex, I find that after he ejaculate and pull out, most of the sperm flows out from my vagina and even after i woke up in the morning the sperm still flows out .. 1 more question , his sperm is quite diluted and slightly transparent. is it normal ? [/INST] Hi, the flow of semen is normal from the vaginal after the intercourse. If you have any suspicion regarding the semen, get a semen analysis done for your husband. It will clear all the doubts. Hope I have answered your question. Regards Chat Doctor. </s>

<s>[INST] I am a woman in my 30s that just got off of birth control about a month ago. I have taken 2 pregnancy tests and they botChatDoctore back negative. For the last week I have been afflicted with constant urination, pelvic/lower abdominal pain, bloating/swelling, and nausea. What could be causing this is I am not pregnant? [/INST] Hi ! Good afternoon. I am Chat Doctor answering your query. From history, it seems like you have got a UTI (urinary tract infection), if pregnancy could be excluded with certainty by the way of serum Chat Doctor estimation and an ultrasound abdomen if need be. I would advise you to go for a routine/microscopic and a culture sensitivity of the urine, and show it to your family physician for further management with appropriate antibiotics after a physical examination of your abdomen. Till then, you could go for an anti-emetic, and a proton pump inhibitor 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. Wishing you an early recovery. Chat Doctor.</s>

<s>[INST] Dr. Agarwal, is wrong, I have an MRI that says that I have a S1-S2 intervertebral disc space. My Question is how much does this affect my lower back pain? I have very bad pain (level 8+) almost continually, and difficulty with other functions. I Know that I, have some pretty serious disc damage from L-5 through T-12. But here lately it s gotten much worse. [/INST] Disc degeneration may lead to back pain however there are too many pain generators in spine, so we need to know more about your complaints and the MRI images to tell you exactly what is the possible reason for back pain. Although you have disc space at S1-S2 but it's not necessary that it is the pain generator. Usually there is no motion at this level, so it may not cause any back pain. Few other reasons could be last mobile lumbar level disc prolapse or sacroiliac joint inflammation. I would suggest getting back WTH more detailed history and your MRI images. Thanks.</s>

<s>[INST] hi my daughter is 5 year old.She is vommiting in the morning after breakfast.After that she will be ok. she will have her breakfast very little amount and not interested to eat in the morning.she is 13.500kg wt only.we consulted a doctor and he gave Emeset and junior Lanzol.sir pls advice [/INST] Hi, Thank you for asking question on Chat Doctor. Your doctor gave the right prescription. But your children weight is less, as 5-year-old child is expected to weigh 18 kg. Better consult pediatrician and thoroughly investigate for the cause. It may be malnutrition, urinary tract infection or even primary tuberculosis. Hope this answer will serve your purposeless feel free to ask any more queries if requiredTake care Chat Doctor. V. Subrahmanyam MD;Disassociate professor of pediatrics</s>

<s>[INST] I m 76 years old and about 5 days ago I started feeling a really sharp pain on the right upper part of my knee. I ve been limping because walking is extremely painful and if I sit for too long I have to stand and wait a while before I can walk....what might this pain be or mean and what should I do? [/INST] Hello, As you are 76 and having pain in the upper part of the knee, have you ever taken an x-ray. Because there should be some degenerative changes of the knee joint and the ligament injuries. Having an MRI or X-ray will be of God choice to understand the pathology. As this pain makes you slow down and locks you up while taking instant movement I will advise you to use the knee brace and do hot water fermentation. Because the muscle spasms need to be corrected, and also the weaker muscles needs support, so the inflammation over the knee joint internal structures do not go high. Also doing some simple exercises like - static Qua Chat Doctor. Additional exercises like straight leg raise on supine lying and side lying will be of benefits. In my clinical practice of over 12 years, most geriatric cases reported with similar pain are advised for exercise in low intensity. They respond well. Hope I have answered your query. Let me know if I can assist you further. Take care Jay In</s>

<s>[INST] I lost my significant other 3 years ago and can t seem to get through grieving. We were having quiet time together and then he went to sleep on the sofa and I went to bed. The next morning I found him dead. I keep reliving this over and over again. I feel I might have missed something or he tried to get to me but was unable to. I cant get this picture out of my head and I can t see me loving someone else. I dont know how to move on. I feel my life has been turned upside down since then. I have family I am around yet I feel so alone. I feel like I don t belong anywhere. I am not suicidal; I cannot do that to my 3 children and grandchildren. Yet life is hard for me. I am also unemployed and having a hard time finding a job. I am experiencing things I have never dealt with and am having a hard time. What can I do? I am already taking antidepressants, which are not working. I have talked to my physician and she is trying to get it changed. But due to this new Obamacare, my old medication is not on the list and the new one is not working. [/INST] Degree understand your concerns went through your details. I suggest you not to worry much. I sincerely suggest that you are doing great. You went through a traumatic and depressive ordeal. For sure. No amount of consolation can equal your fate. But you also should understand that such things happen with almost everyone. Everyone loves their better half or spouse. When such things happen, even when they were at young age, it is normal for them to go through some depression. But they shall understand that they have to move on. They have duty to do. Secondly, you were doing the same for the last three years. That is great. If you have any mental disorders, you cannot do so. You must add to your self-confidence. What you can do now is, understand what life is. Even you are a guest here. Your spouse went because his time had come. When your time comes, you shall also join him. That is life. Depression is normal, but we should overcome our emotions. Everybody, every human being does. Then why not you? If you require more of my help in this aspect, Please post a direct question to me in this website. Make sure that you include every minute details possible. I shall prescribe some psychotherapy techniques which should help you cure your condition further. Hope this answers your query. Available for further clarifications. Good luck.</s>

<s>[INST] Hi,I am 24 years old.i had my last period on the 2nd of july and it lasted about 4 days. I had unprotected intercourse on the 12th of july and I used postinor 2 1 hour after.i dont keep track of my menstrual cycle but I am scared of getting pregnant. I dont have any symptomsjust being having cramps.pls help me. [/INST] Hello, please do keep record of your menstrual cycle to predict the day of ovulation and decide the safe and unsafe period for yourself. If you had regular cycles then ovulation takes place 14 days prior to the start if next menstruation. 4 days before and 4 days after ovulation is the unsafe period in which couples should avoid having intercourse. If you have a regular cycle of 30 days then you had sex in safe period plus you took posting 2 within 24 hours which means very less chance of getting pregnant. Posting has its side effects as well, so these cramps might be due to the medicine.</s>

<s>[INST] I have just returned from Venice and have multiple bites. they started on the last day, but now im home, i am continuining to be bitten. The lumps are small pin prick bites and when scratched, the area around it goes white and hard. please help. have i brought something home with me? [/INST] Hi, dear. I have gone through your question. I can understand your concern. You need examination. What kind of bite marks are there. It may be some skin disorder or may be some self-inflicted mark in psychiatric disorder. So consult your doctor and go for examination. 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] Excessive tiredness, sleep needed about every 2 to 3 hours. When I lay down I fall sound asleep for about 1 hour. Always tired, heavy eyelid feeling. This behavior has started within the past 3 to 4 months. I am 85 years old. I have a heart condition and arthritis and take several medications that can cause tiredness and dizziness but I have been on these medications for a very long time. Had a cardiac oablation done in September of 2013; could this have been the start of this tiredness & dizziness? Thank you. [/INST] Hi, Your complaints may be caused by some abnormalities such as low Hemoglobin or electrolyte disturbances, also abnormal glucose values may cause sucChatDoctorplaints. I would advise you to have done complete blood count, serum electrolytes and glucose. Also monitor your blood pressure and pulse for a week. Take fearsome back if you have any further questions</s>

<s>[INST] this question is regarding urinary tract health.during the past few weeks I have felt a non ending urge to urinate that has not and will not go away. I have been drinking a fair amount of water and cranberry juice to help clear out any infections that may be present. is there any other suggestions that could help with my problem that would not require a professional? [/INST] Continue to consume juice and water for a few days and if continue to have the same concerns you need to make an echo of kidney (or abdominal echo in general) and urinary compete analysis I judge that you should start a treatment after the response of analysis</s>

<s>[INST] What causes shingles (other than the compromised immune system)...poor nutrition, stress, lack of sleep? My 76 year old man friend just broke out and he will see a doctor tomorrow, but I would like to know the why and how we treat it. Am I liable to become infected if we are intimate? What is the incubation period? What is the standard treatment, please? Is the condition likely to return again? Thank you. Gina email: YYYY@YYYY [/INST] Hello, Thank you for asking at Chat Doctor. Shingles generally happens due to a virus that sleeps in the neurological system on a person that has had chicken pox before. This is very common especially in cases you mention, but elderly age is a reason also. It is generally self limiting but very uncomfortable meanwhile. There is oral acyclovir he might use to speed up healing, it should be started as soon as possible and there are Chat Doctor. Local cold compresses can help with pain also. As for you, you are not in risk if you are not in contact with the fluids that come from the vesicles. Very little chance it will spread to you by contact, it generally comes from the inside of the patient (the sleeping virus) but to be safe please try to avoid contact with the area that has the vesicles. I hope this is helpful and answers to your question, but please feel free to write us in case more clarification is needed on this. Kind regards, Antoneta Total, MD</s>

<s>[INST] I was doing some sweeping of my house yesterday. Ever since the I have been extremely dizzy. I have had at least 9 concussions and have neck issues. I also have 2 buldging discs and have had a compression fracture of my spine. I have done some research and think it could be Cervical Vertigo. [/INST] Hi, From history it seems that this problem might be due to pinched nerve pressure due to problem in your cervical spines. While giving uneven pressure on neck like sweeping or nodding movement at neck might give pressure causing nerve irritation producing pain or vertigo. Go for neck exercises, cervical traction, short way diathermy etc. Avoid putting pillow under the neck while sleeping. Ok and take care.</s>

<s>[INST] I have a bad smell coming from my nostrils it the smell you get usually when your sick and you have a congested nose or something, but I have the smell all the time and wont go away no matter what the doctors at my clinic tell me to do. My nose gets really stuffy at night only in one side. But I also have bad breath I can brush my teeth and an hour later it wont smell fresh anymore. And sometimes I have postnatal drip. [/INST] Hello and welcome. Please let me know when did you last visit your ENT specialist?There could be a sinus infection. Why do not you meet ENT specialist and get an x-ray done for sinus. Once you get the reports, start with decongestants. It does not appear to be dental infection as per the history posted here.Meanwhile, you can do warm saline rinses and do steam inhalation for immediate relief. Hope it helps. Thanks. Take care.</s>

<s>[INST] I do masturbation in prone way by lying down against pillow of floor. I never had any problem with this method. However, I have read that doing masturbation in this method puts pressure on penis and people who do that will not have good pleasure during normal sex. Is it true? [/INST] Degree understand your concerns went through your details. I suggest you not to worry. The position you are taking is safe and normal. People invent numerous methods and most common are hand masturbation and your style. This method is adopted by millions across the globe and none of them had this problem. You can enjoy sexual life for sure. There is one advantage with hand masturbation. After some time, the penis slightly bends towards right or left. This bend penis shaft gives more pleasure during sexual intercourse than straight penis. Hope this answers your query. Available for further clarifications. Good luck.</s>

<s>[INST] I got a skin rsh, red spots and itchy from going in a pool and hot tub for physical therapy. Have stopped going to the pool but the rash keeps returning after seemingly going away. Dr has given me a cream and I am using lotion.. Cant be laundry detergen as wife uses Purex hypoallergenic. [/INST] HIT hank for asking to ChatDoctorYou have to first keep your self away from the causative factor, and you better take the oral anti-allergic medicine and the good choice is "Tab Levocetrizine 10 mg three times in day" for some days, hope this information may help you, have nice day.</s>

<s>[INST] My son is 21 and healthy. He came to me last night feeling dizzy and nearly passed out. When he felt a bit better, I took his BP. It was 116/53. THat seems low.Could that have triggered the dizziness? He seemed to be fine after he ate CHerrios with bananas and sugar. [/INST] Howell come to ChatDoctorI really appreciate your concern, the dizziness may not be significant because no associated history is there even the blood pressure may not be the cause, the most common cause at this age is hypoglycemia, if this is being happened first time still condition needs to be kept under observation for further episode because it could be let onset of epileptic seizure. Advise:- Ct brain is must, with routine blood work, EKG. Hope this information helps.</s>

<s>[INST] Hi, I am a 54 year young lady and in 2002 I was diagnosed with invasive squamous cell carcinoma in my righr sinus cavity. After my face was layed open and tumor removed then went through 29 radiation treatments, and all has been great until a few weeks ago I have started having simular symptons and I waterpick sinus cavity now at least 3-4 times a week. Any suggestions? Thanks,Robbin [/INST] Hi, Thanks for writing in. Squamous cell cancer of the sinus cavity might become recurrent in some people. It is important that you follow up with your doctor and then get evaluated for possible recurrence. Medical literature says that squamous cell cancers have definite metastatic potential, and patients should be followed regularly after initial treatment. Overall, local recurrence rates after treatment of primary cancer ranged from about 3% to 23%, depending upon anatomic site. About 58% of local recurrences manifest within 1 year, 83% within 3 years, and 95% within 5 years. Please consult your doctor at the earliest and take treatment should there be any recurrence. Please do not worry.</s>

<s>[INST] I am Titir Mukherjee, 35 yrs married woman.have started trying to be a mother. meet Doctor. he asked me for USG. The report of USG shows :1. mild heterogeneous cervix2. Right Overy Bulky3. a cyst without any internal echo is seen closed to itwhat should my next steps for medical test?Is there any risk for being pregnant? [/INST] Hello. Thanks for writing to us. The mildly bulky right ovary without any polycystic appearance of the ovary may be a normal finding. You can conceive with the help of ovulation induction therapy. Do get it prescribed from your gynecologist. I hope this information has been both informative and helpful for you. You can consult me again directly through my profile URL http://bit.ly/ Chat Doctor. </s>

<s>[INST] i quit smoking a little over a month ago. for a month now i have had the strong, uncontrollable cough with phlegm and i am always out of breath which makes me lightheaded. i also have had some fevers here and there. also my nose is stopped up a lot. every time i blow my nost the back of my head and neck hurts so bad. [/INST] Thanks for your question on Chat Doctor. I can understand your concern. Since you were a smoker, we should rule out lung infection and bronchitis in your case. Both these diseases are common in smokers and cause similar symptoms like cough, expectoration, fever and breathlessness. So better to consult pulmonologist and get done 1. Clinical examination of respiratory system. 2. Chest x-ray 3. PUT (pulmonary function test). Chest x-ray is needed to rule out lung infection. PFT is must for the diagnosis of bronchitis. You will mostly improve with antibiotics, inhaled bronchodilator, inhaled corticosteroids and other supportive Chat Doctor. Don't worry, you will be alright with all these. First diagnose and then start appropriate treatment. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.</s>

<s>[INST] Hello, I have been having problems with my feet and ankles retaining water, for at least two months now. Went to the doctors, he gave me water pills but they aren t helping. My mother has a thighroid problem and I was told it could be passed on from mother to daughter and so on. I have been putting on weight all of a sudden, and usually I can control the weight but now I cant. Could all of this be caused by a thighroid problem? [/INST] Hi, thank-you for providing the brief history of you. As you have thyroid problem I think it should be hyperthyroidism, since due to This there are chances of adding on weight and also the legs feeling fluid retention. The first foremost thing required is to check the thyroid levels in your body. Undergoing a TSH test should help understand the levels. Post which the medication has to be used to control the levels of thyroid in blood. Also, along with medication you need to perform regular physical exercises as the combination of Chat Doctor. There will be a slowness in the physical activity of your muscles due to thyroid issue leading to early fatigue and reduced metabolism. Having a combination of </s>

<s>[INST] I have been to the doctor several times for recurring pain in my chest. Its right in the middle sternum and it feels tender to the touch and comes and goes for months now. It hurts when I move like standing up from sitting down. What else do I say to get some kind of response ? [/INST] Hello, Regarding your concern, I would explain that your symptoms are not typical of any cardiac disorders. A musculoskeletal pain (including Costco Chat Doctor. Coming to this point, I would recommend taking ibuprofen for the pain. If the chest pain persists, I would recommend performing some tests: - a resting ECG and a cardiac ultrasound- a chest X-ray study-complete blood count, PCR, ESR for inflammation. Hope I have answered your query. Let me know if I can assist you further.</s>

<s>[INST] After training for a half marathon last year, I discovered what feels like a small lump behind my shin. I feels very bruised when I push into it and can give me a bit of discomfort. I massage it frequently and feel like it is gradually getting smaller. Should I continue doing this or get it checked out? [/INST] Hi. Stop massaging. Consult a Doctor to know the reason - whether due to small rupture of small blood vessels or what? You can keep the lower limbs in elevated position, higher than the heart level in the lying down position. Use crêpe bandage or stocking during marathons</s>

<s>[INST] what should i do about severe body /arm and leg tremors. Im scared to take any medications that i was prescribed for sleep/depression/anxiety because of this severe tremoring . I have been basically totally inactive for weeks and lost about 4 kilos and i think this may have caused the tremors because my heart feels extremely weak. I dont want to cause a further problem by taking a medication for 2 weeks. Should i get my heart and cardiovascular system checked before taking and medications. It feels like i am almost going to have a heart attack when i lay down and my whole chest tremors.I even fear i may have already had a small heart attack or something. im 37 and my appearance looks normal/a bit thin. What specific tests should i get done? [/INST] The tremors in arms/legs and chest tremors (palpitations) are likely to be due to anxiety. You should give a trial to the medicine prescribed by your doctor. At this stage, in my opinion, the symptoms are likely to be due to an anxiety disorder. When you follow up with your doctor, you may ask questions you may have about specific medicines. You may consult a psychiatrist if your doctor is a general practitioner. A psychiatrist is a medical doctor specializing in psychological and behavioral disorders (including neurological disorders with psychological symptoms). A psychiatrist is in the best position to judge what tests to order in the beginning and whether to seek additional consultation of a cardiologist or any other specialist. I hope this answers your question.</s>

<s>[INST] HAVE BEEN EXPIERENCING WHAT THEY CALL BRAIN ZAPS FOR ABOUT A WEEK NOW. ON 40MG OF SELEXA AND 150MG WELBUTRIN BUT STARTED WITH THE ZAPS SO WENT DOWN TO 20MG SELEXA AND KEPT SAME DOSAGE OF WELBUTRIN. GOT A COLD AND HAVENT TAKEN EITHER FOR TWO DAYS NOW AND AM GETTING ANXIETY BUT ZAPS HAVE MINIMIZED. SHOUL I PROCEED THIS WAY AND BREATHE THROUGH ANXIETY? [/INST] Hi, Welcome to Chat Doctor forum. It is confirmed the brain zaps are due to the Selena, you have stopped it now. Welbutrin alone may be sufficient, if your doctor feels it is not sufficient, he can prescribe some other medicine from the thousands of other Chat Doctor. Take more of green leafy vegetables, pulses, sprouts, and protein rich foods to have good health resistance against the infections. Practice yoga, meditation, reading books, and hearing music as diversion procedures. Wishing for a quick and complete recovery. Thank you.</s>

<s>[INST] I was suffering from impetigo due to a bacterial infection on my face and it spread to many areas of my face which caused the skin to peel off and become raw. After taking oral antibiotics and applying triamcinolone acetonide 0.025% ointment on my face, the skin healed. However, they healed brown. Why did it heal brown and how can I make them fade away quickly? [/INST] HelloWelcome to Chat Doctor, Impetigo is a skin infection caused by the bacteria Staphylococcus aureus or Streptococcus Diogenes, and it causes fluid-filled spots or blisters. Usually it will be a small fluid-filled spots that are about 1 to 2 cm in diameter and rarely be able to see these because they will quickly burst and then crust over and turn yellow and honey colored. The spots will eventually Chat Doctor. You will normally need antibiotics either as a cream or orally to treat the infection and to prevent you infecting others. Antibiotic cream called juridic acid are effective in clearing up most impetigo infections within seven days, and you will need to use it two to three times a day. If the infection doesn't clear and widespread you may require oral antibiotics like flucloxacillin and azithromycin. Thank you.</s>

<s>[INST] About a year ago I broke the toe on my left foot. I chipped a piece of the bone off. You can see it on the xray. Over the last couple of months I have been getting pain in this toe. The pain feel like a hot flush and lasts between five to ten seconds. [/INST] Hello, Due to somatosensory disturbances, there will be disturbed sensation like hot flushes. Doing icing will be good and simple foot muscle strengthening exercises will help reduce the symptoms. Hope I have answered your query. Let me know if I can assist you further. Jay In Chat Doctor. </s>

<s>[INST] My dad is 70yrs old and was diagnosed with ca of prostate in 2007. Surgery was done to remove the testicals in order to reduce the production of testosterone. From bone biopsy we found that it has spread to bones and chemo was done for 2 cycles out of 3. the last one could not be completed because of severe side effectsHis hb keeps reducing every 3-4 months and he requires transfusion. Is there a way to avoid this and increase the hb naturally? He eats a very healthy diet rick in iron but effect of Hb is slow [/INST] We Use in our patients Erythropoietin 10000 units every 2 weeks. You can consult your doctor who can guide you the form and route of administration. Truly,</s>

<s>[INST] My 4 and half year son got the USG report of whole abdomen, it is mentioned that Liver is slightly enlarged in size homogenous parenchymal echotexture. No sizable focal lesion seen. Infra hepatic biliary radicles are not dilated. Portal hapatis measures 7 mm. kindly suggest for this. Kindly not that he doesn t want to have any meal at any time. We have to forcefully feed him and it takes more than one hour to feed him every time. Moreover sometimes he vomit too. kindly suggest. [/INST] Hi and welcome to Chat Doctor. You should do liver enzymes findings. The most common liver disorders which is found by ultrasound is fatty liver which can be found in healthy people, but usually is resulting from elevated blood lipids, overweight and elevated blood sugar. If ultrasounds didn't find anything and viral markers are negative then you have no reason to be concerned. You should treat it by changing dietary and lifestyle habits. Do exercise, avoid alcohol, smoking, fats, fast food and carbonated Chat Doctor. Eat more fruit and vegetables, boiled meat and follow some of hepatoprotective diets. Findings usually improves on such measures. If not, then some medicines can be prescribed, but I suggest going step by step. Wish you good health.</s>

<s>[INST] Every time I cough I feel excruciating pain in the middle of my chest. It feels like something is going to explode in my chest. I also have the chills then the sweats. I do have asthma but it does not bother me. I am taking 2 I hailers ( Advair and salbutamol ) iv also been taking clonazepam to help me sleep. I have no appetite and am feeling very weak. When I cough I cry from the pain. Nothing comes up when I cough. It s just a dry cough. Please help me [/INST] Hi Kellstarr, Thanks for writing your query. Afterreadingyour post, it seems that the pain you are experiencing can be due to muscular in origin due to excessive coughing. The inhalers you have mentioned will help in bronchodilatation and help you in asthma. For Chat Doctor. I would suggest that you should have following investigations done :-1. Complete Blood Count(CBC).2. Absolute Eosinophil Count.3. Chest X-Ray (PA view).4. ECG. Steam inhalation can also help in relieving your symptoms. You should eat fresh fruits and vegetables for increasing the immunity and regaining health. If the problem persists, get yourself examined clinically. I hope this is helpful to you. Thanks.</s>

<s>[INST] Hi, I have a 6 year old in perfect health. I noticed about 4 days ago that her lower lip was blue. I figured it was from sprinkles in a donut. It is still very much there 4 days later. She just had a bath and although the water was very warm, it was a very dark blue. What could be going on??? [/INST] Hello, As the lip looking blue even with warm water, it may be due to some vascular malformation. Please consult a local doctor, as he will examine the child and diagnose it. Hope I have answered your query. Let me know if I can assist you further.</s>

<s>[INST] I am a 30 year old female with sharp pain in my chest. Its sharp and difficult to breathe. I went to the doctor Monday due to lower back pain, nausea, and upper stomach pain and sensitivity to touch. He gave me cipro, my chest hurts and I am still nauseous. Im feeling pretty silly sitting outside the ER for it to get bad but if its just acid its going to be a big bill. Should I wait to see another doctor before going into the ER? Im athletic but just quit smoking after 16 years, high stress [/INST] Hello, You need to do -An electrocardiogram.-A chest x-ray.-A 2D echocardiogram. I have advised the above since you are at high risk, given your long-standing history of smoking. Hope I have answered your query. Let me know if I can assist you further.</s>