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<s>[INST]gud morning doctor. m from bangalore n suffering from sinusitis for many yrs....been to many ent specialist, but i get only temporary relief..n m allegic to dust , coz sometime i sneeze a lot...though i avoid cold drinks. n ice cream...i think m allergic to dust n damp..not sure. i want to find out wat m allergic to also..plz help me...[/INST]HelloWelcome to ChatDoctorYour history and symptoms suggest me that you are having some allergic manifestation which should be treated properly. I would suggest you to undergo lab investigation like Absolute eosinophil count to confirm the presence of allergic reaction. I would suggest you to undergo skin prick test with allergens like dust, food, mite and pollen. This will help to identify the allergen so that we can plan proper treatment. Thank you.</s>

<s>[INST]I have had rhinitis a very long time. Constant runny nose and sneezing multiple times a day every day for the past few years. No fever, no headaches except minor headaches due to the congestion build up which only happens once or twice a year. What could I do?[/INST]HelloPlease note down these things about allergic rhinitis:Inflammation of the nasal membranes with major symptoms and sings :-Nasal itching-watery rhinorrhea-nasal obstruction-sneezing -post nasal dischargeOthers may be :Headache (as sometimes in your case)impaired smell morning coughconjuctival symptoms, eye pruritusAs in most patient these symptoms present. Reason is clearly due to allergy, allergens may be ;Pollen, mold, fine dusting powder, sudden change of temperature, dust, hay, fodder, smoking, pests (cockroaches). If possible avoid these predisposing factors. Measures:Use allergen-impermeable covers for mattresses & pillow swash sheets and blankets in hot water, every week.vacuum-clean beds every week clean furniture in to be Chat Doctor. Use reconditioning.Don't allow animals in house. When such patient visit my clinic I advise them to take montelukast + levoceterizine. But if breathlessness present I advise my patient to take montelukast+ albuterol tablet once or twice in day and this provide complete relief. Whenever necessary take these tablets, and stop once relief. Recurs, take again. Hot coffee and steam inhalation also provide relief in such cases. Good luck.</s>

<s>[INST]Lately, I am becoming allergic to almost everything. I would have rashes to every medications being prescribed to me by doctors. I am reacting to soaps, toothpaste, eye drops, clothes, gloves, a lot of foods. I am having shortness of breath, even if I am just watching TV, sitting , surfingthe internet, almost very thirty minutes, then will break after 10 mins, then short of breath again. Am I having an inflamed immune system ? Is there a cure for this? What should I do to get back to my previous health? This started 6 mos ago.[/INST]Hello dear, thanks for your question on Chat Doctor. I can understand your situation and problem. Since you are having strong allergic history, possibility of bronchial asthma is high. Bronchial asthma is allergic disease, which causes bronchospasm and thus breathlessness. So we need to rule out asthma first. So consult pulmonologist and get done1. Clinical examination of respiratory system. 2. PUT (pulmonary function test). PFT is needed for the diagnosis of asthma. It will also tell you about severity of the disease. And treatment of asthma is based on severity only. You may need inhaled bronchodilators and oral antihistamine and anti-allergic Chat Doctor. So consult pulmonologist and discuss all these.</s>

<s>[INST]im 23 mised period of 11days,had sex 3days from oct 11,took postcoital pill,i took home pregnancy test today n daybefore there was very faint pinkline in test region apart from purple line at control.am i pregnant?if yes what is the best place n method of termination of pregnancy,im unmarried.[/INST]Hello dear, I understand your concern. In my opinion though the urine pregnancy test is positive faintly it means there is pregnancy. Might be postcoital pill was not effective in preventing the pregnancy. Usually the postcoital pill is 95% effective if taken within 72 hours of unprotected sex. I suggest you to undergo termination of pregnancy only under doctors supervision because the abortion pills are associated witChatDoctorplications like heavy bleeding, incomplete abortion etc. The termination of pregnancy by medicines is possible only up to 6-7 weeks and if that period is passed minor surgical procedure like D&C is needed. Best regards...</s>

<s>[INST]Hello, i am from Romania. I had in April a breast surgery, bening tumor finally. I had in that time a strong muscle contracture when they tried to eliminate lymph (I was afraid of the needle!). I didn t know that I will have lately a big problem with my arm! Now I make terapy (kineto+massage) for recovery my blocked arm (they said). During these 3 weeks no changes. Do you consider i need infiltrations with corticoids?[/INST]Hello, Its a matter of happiness that your tumor was benign and non-harmful in nature. Looking at your detail it looks that most probable reason behind your arm contracture was lack of proper physiotherapy during recovery period. In such cases the physiotherapy is the best option, although it may take some time as recovery is gradual in nature. Meanwhile, you may add a muscle relaxant like thiocolchicoside or chlorzoxazone on recommendation of your doctor to relieve muscle spasm. Hope I have answered your question. Let me know if I can assist you further. </s>

<s>[INST]Im a 28 year old female... Been running low grade fever nonstop for 3 months. passed 2 stones already, no more seen. Im still having extreme kidney pain as well as severe pain in right lower pervic area... Antibiotics took care of kidney infection , but STILL have large amounts of blood and glucose spilling out in urine. All labs wer normal except Low AST and thyroid was 0.1 away from being low .... Also, no appite, on/off nausea to go along with fever... Any ideas?[/INST]His blood is coming in urine, you should be investigated thoroughly. It can be due to Kidney stone, Tumour, Infection. Please get an Ultrasound abdomen, Intra venous paleography(MVP), Urine test for malignant cells and analysis. Till then, take good antibiotics like Balofloxacin, Cefuroxime. Add Paracetamol tablet too. Chat Doctor. If glucose is present in urine, please exclude Diabetes after consulting the physician. Keep the blood glucose levels normalEverything will be alright. If you come back with above test results, I will clarify further. Wish you speedy recovery. Regards</s>

<s>[INST]hello sir...i am sara. n i am 26 year old.. my weight is 43 & height is 5 5......nowdays i am feeling very weak ,, neck stiffnes, shoulders pain, opposite t0 lungs center of back pain.... having issue to taking breathe also... feel nausea sometime also....having svere muscular pain,,,, please recommend something.[/INST]Welcome to Chat Doctor I have gone through your query and understand your concern. You may be having some kind of viral infection. So I think you should visit physician for check up and treatment. Till then rest and analgesic such as ibuprofen may be of help. Vitamin and mineral supplements will be helpful. Take high protein balanced diet. You can discuss with your doctor about it. Hope your query get answered. If you have any clarification then don't hesitate to write to us. I will be happy to help you. Wishing you a good health. Take care.</s>

<s>[INST]Hi Doctor, My husband is type 2 diabetic from last 2 years. And his sugar levels are in control. he didn t take any medicine for last 2 months.. and his recent report for average blood sugar is 6.4, before fasting 140 and post food 150... what medicine is recommended to keep sugar under control.. he was taking carbophage 500mg morning and night.. He feels the dosage is more, please suggest.[/INST]Advise:1. Diabetic diet, i.e. no to sweets and eat in plenty all leafy vegetables, sprouted pulses and regularize timings and quantity of meals.2. Regular exercise (Weight reduction if obese)3. Check Blood sugars after 15 days, if normal; check every 6months.4. Regarding dosage, you should consult your attending physician for adjustment of the dose.5. If a good control is maintained by a very small dose, then stop the Chat Doctor. </s>

<s>[INST]i have been having strong kidney pain in the right kidney. it comes and goes i went to my doc the other day and got xrys and ultrasound done however she did not see anything tonight the pain is very consistant i drank large amounts of water to try and flush the kidney out.should i do something else?[/INST]Hi, dairy have gone through your question. I can understand your concern. You have strong and consistent kidney pain. It can be due to kidney stones. You should go for repeat ultrasound kidney, ureter and bladder. It will give you exact diagnosis. Chat Doctor. It is prescription based medicine so consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using Chat Doctor. Wish you a very good health.</s>

<s>[INST]Sir I am 31 yr old man serving in military engineer services as a junior engineer. Sir I was suffering from mental problem in 2001 I got checkup my self from AIIMS IN Phyciatry DEPT IN MAY 2001 DOCTOR TELL ME THAT I HAVE OBSESIVE COMPULSION DISORDER THEN I TOOK MEDICINE FROM 2001TO2005 AFTER THAN I GET RID OFF FROM THAT PROBLEM .NOW FROM SIX MONTH DUE TO FAMILY PROBLEM AND OFFICE PROBLEM , I HAVE FACING LACK OF SLEEP,FEARING OF MISSHAPPENING DURING BIKE RIDING AND OFFICE WORK ,MIND BHARI HO JATA HAI . what is the theproblem now. PRASANT AMBALA[/INST]Hello Mr. Prashant, From your symptoms I think it is possible that you may be suffering from another exacerbation (worsening) of obsessive compulsive disorder (OCD). OCD is usually a chronic illness, which means that it does not get cured completely. With medicines, it can be brought in control (like Diabetes or Hypertension), but during stressful situations the symptoms may return. You seem to be facing some stress at home and at work; probably this stress has triggered another episode of OCD. Another, though less likely, possibility is that you are currently having an anxiety disorder other than OCD. A confirmed diagnosis would require a face-to-face consultation. It is very likely that you will benefit from the same medicines that had helped you earlier. I recommend you visit a psychiatrist for a face-to-face evaluation and consider restarting those earlier medicines. More importantly, please do not stop the medicines on your own in the future.</s>

<s>[INST]Hi, i am 39 yrs old and have always felt need for a adhd drug. I get anxious v quickly (end up biting nails), i skip between topics and have had difficulties in focusing. professional life has suffered recently and personal life has always been below avg i wld say. So i decided to start with attentrol 10mg. Trust there are no side effects.. thx[/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. There are no significant side effects with attention. But you have significant anxiety symptoms which cannot be explained with ADHD alone. You may start your treatment of ADHD but after some days you will have taken an independent treatment for anxiety disorder as well. 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]I am from Pakistan having problem of Hepatitis C, First it got Uniferon + ribazol for about 9 months but result finally was detected. In the meantime, I was using Liv 52 one tablet daily and feeling good. But doctor suggested to go for PEGASYS + RIBAZOLE 400MG, but after 13 injections result obtained was not 2 log, so again doctor ask me to stop treat and go on Liv 52 1+1. But If I take 2 tables daily I feel further weakness and dizzy. Because of this reason I unable to do my office work properly.Whereas doctor and Live52 advisor ask this is a very good supplement but your said complain probably because of any other reason. Now suggest me what to do, my age is 47[/INST]Hello, Thanks for the query to Chat Doctor. Forum. Since, you have full treatment of hepatitis C, but, what about the report at present ? Also mention the reports of liver enzymes such as S G O T, S G P T. bilirubin, c p k, Amylase (pancreas). Liv 52 are commonly used Chat Doctor. In my opinion it never causes any weakness. So your age is at present 47 years and this age is prone to many diseases. Consult a physician and get in blood for C B C, E S R, sugar, lipid profiles. Routine blood pressure is also important. Hope I have answered your question. If further any question I will help. Get well soon. </s>

<s>[INST]Hello dear ladies and gentlemenI have a very big problem. 2 years ago I had a sudden nasty taste in the mouth because the tongue has stunk bad. I thought it would be normal after a year I could no longer stand in the school had to remain quiet all the time and if someone came to me and walked away because I have i.wie gum did not help anymore, I went to otolaryngology doctor had ignited my almonds were rausgeholt nothing has improved. it is so I have intestinal blockage problems, etc. but Im sure the smell is directly ausdem mouth when I smell it themselves and many have told me. is my tongue white lining at the back when Im away he goes away the covering ganricht i.wie is connected to the tongue that is just look like white tongue. if I take hold of the finger behind the tongue and smell it. It really smells like feces after and when I bit my finger with further direction gullet go quite so far down it smells slightly better but still bad eggs out after. I probably know this mushroom diet nystatin been taken nothing has helped Latin hospitable 3 times already because my GP thought I vill have displayed the stomach. heartburn but Ive never understood, and the odor comes from the stomach is not coming directly from behind and in front of the tongue on the tongue, it smells disgusting and tastes disgusting years since 2 is the second time for 1 gemack not go away no matter what I used who Ive always behind the tongue or just touched my tongue and then smelled my tongue, it had always smelled disgusting. chewing gum not help me no doctor helps me because Im patient, Ill cash out sent to 5 minutes, and prescribe unnecessary medium. I have been suffering with depression is 17 am destroying my life just do not even go to school I will: (... need help before I drigend what wrong doing ....[/INST]Hi.I have read carefully your query. First u say u have depression the did u visit psychiatrist ever??? Bcause if u didn't than u must. Sometime this type of genuine complains are associated with mental illnesses. If your complaint is without any medically reason than it fall under category of medically unexplained symptoms means aromatization. Aromatization and depression are comorbidly present. And second thing it may mimic olfactory referral syn Chat Doctor. Both of this aromatization and olfactory referral syn</s>

<s>[INST]hi,i am 35 i usually have a regular cycle that lasts 30 days , this month to delay my period i used priolut-nor of the past 3 days ,i am on the 28th day of my cycle now ,if there was a chance that i might be pregnant could this medicine have harmed my fetus already? could a blood test at this stage confirm pregnancy?[/INST]Hallow Dear, Primolut is a progesterone preparation. Progesterone is required to stabilize the pregnancy. In some cases where there is progesterone deficiency, we give progesterone to the mothers. So you need not worry about it. However, you are not sure whether you are pregnant or not. Moreover, you have taken Primal, so your menses will be delayed. Please do not become panicky for delayed menses. After you have discontinued the Primal, you should get menses within 4-7 days. If you do not get them even after 10 days, then you may get your urine tested for detection of pregnancy. Till that relax. </s>

<s>[INST]Having chest pain, pain in left shoulderblade, and down left arm. Been to ER and cardiologist and all test show I have a healthy heart. However, the pain is sometimes unbearable, I am very tired. I don t eat fried foods. Feels like pain may be in lungs. Any suggestions?[/INST]Thanks for your question on Chat Doctor. I can understand your concern. First no need to worry about heart diseases because you're all cardiac tests are normal. Sometimes undiagnosed stress and anxiety can also cause similar symptoms. So avoid stress and tension, be relaxed and calm. Consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on its solution. You may need anxiolytic Chat Doctor. Apply warm water pad on affected areas of chest and shoulder. Don't worry, you will be alright with all these. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.</s>

<s>[INST]hello!im 33 years old,with elevated level of SGPT since 3 years now.It started after my 2nd delivery,my phsician prescribed me some medicine such as,ursufalk and legalon but still my sgpt level is going up and down please help me...and more power thank you..[/INST]Hi, SGPT is indicator of liver damage or injury from different types of diseases or conditions, and collectively they are termed liver tests or liver blood tests. So the next step is to look for certain liver damage and most common cause is fatty liver disease. It should be confirmed by ultrasound. Other causes are viral hepatitis, cirrhosis, medications, alcohol intake or autoimmune diseases. To verify exact cause, US, bilirubin levels and tumor markers should be additionally done. Then appropriate treatment can be started. I hope I have answered you query. If you have any further questions you can contact us in every time. Wish you a good health.</s>

<s>[INST]Thank You. I have Hep. C, and I was told by my Dr., to stay away from Acetomenophen, but I can takeIbuprophen. Is motrin an ibuprophen? Secondly, what are other options for pain relief and/or fever reduction? Is there a list of yes & no for a person with Hep. C?[/INST]Hello! Thanks for putting your query in Chat Doctor. I am a Gastroenterologist (DM). Acetaminophen is rather safe until it is taken in safe dose that is less than 4 gm per day. Ibuprofen is rather unsafe as it can cause hepatitis. For pain, you can take tramadol also which is safe for you. Avoid alcohol, any Chat Doctor. Get vaccination for hepatitis B and A. avoid high fat diet. DO regular exercise. Take lots of fruits and vegetables as they are rich in antioxidants hope I have answered your query and this will help you. If you have any further query I will be happy to answer that too. Remain in touch and get-well soon.</s>

<s>[INST]Hello, I noticed a lump on the middle part of my daughter s shin last night. It seemed go come out or no where . She is a very healthy and active 5 year old girl. There is no bruising around area and she said it doesn t hurt which is concerning. At first I thought she bumped it but with no bruising I am concerned. her Father has lots or fatty lipomas, I believe it s called durkam s disease. Could this be what they bump is? Also fear could be cancer . Worried out of my mind![/INST]Hi.... Hi I have just read through your query. Sudden appearance of lump can never be a cancerous lesion. So do not worry about this. I can Hun Chat Doctor. Other possibility is that it could be an insect bite allergy or a small bruise which could have been due to injury which has been overlooked. Rare possibility is that it could be because of a bleeding disorder which needs evaluation. Whatever it is I suggest you consult your pediatrician regarding this. Regards - </s>

<s>[INST]What are some quick natural remedies for acne??? Recently, Ive been getting a lot of under the skin pimples that leave marks lasting for a couple of weeks. Im 23 now; I used to have a lot of acne as a teen, but it cleared up. Although I dont have a lot now, there are a few big ones popping up in the same spots over and over again. Any suggestions?[/INST]Hello, Thank you for posting here your question. Acne, especially in buys, are related to hormonal levels in the body. What you can do, is to be careful the won't get infected, because that may make those worse. For this reason, is recommended to wash the face gently, with special soaps sensitive for the face, that can be used in acne, twice/day, and with being careful not to rub the places where the pimples are coming out. Also, being careful with your diet, sometimes help-Low intake of sugar foods and fatty foods. Feel free for further questions if you have any.</s>

<s>[INST]In October I went to the doctor for a yeast infection. They took a swab and said I tested positive for yeast. They prescribed me diflucan. The medication worked. In December my symptoms reappeared. I was prescribed a second round of diflucan. This did nothing to relieve my symptoms. I self treated with yogurt and a vaginal steroid to restore ph. It did relieve the itching and irritation. But I still went back to the doctor. She told me to keep doing what I was doing and scheduled me to see my OBGYN in 3 weeks. I have been told to use Rephresh gel applicators and was prescribed a steroid cream. I still have my symptoms external itching and my skin is very dry. Any suggestions in how to get through the next few weeks until my appointment with the OBGYN?[/INST]Hi, I have read your query & realize your concern. * Yeast infection is associated with white /curd like vaginal discharge & is notorious to recur, unless treated adequately. Mostly it is sexually transmitted problem, so treatment of both sex partners (both oral & local treatment)is advised-till the infection is completely eradicated. The infection tends to recur-so abstinence & repeated therapy is given to remove the infection en root. * The recent itching you have does not seem to have any discharge(as you say skin is Chat Doctor. Still vaginal swab testing should be done before treating it for yeast. * In some conditions like Allergy, antibiotic consumption, hormonal therapy, pregnancy, menopause, diabetes HIV . Disturb normal vaginal flora & causes </s>

<s>[INST]hi Dr. i have been pescribed for omnacortil20 for sarcoid and stared taking madecine since last four days. today morning i found bleeding fron my testicles skine. i would like to know whether it is a side effect of the madecine please advice regards sourav[/INST]Hello, Omnacortil is a steroid medicine and has nothing to do with bleeding. Long term intake may make your vessels and skin fragile and thinned out. Bleeding tendency is not a feature of sarcoma even. So it needs further work up. You should do a simple blood complete picture. And observe for bleeding from any other site. If you have any other symptoms, do mention them too. Hope I have answered your query. Let me know if I can assist you further. </s>

<s>[INST]my husband has had a chronic skin rash for 8 months andnow ha pussy postules in the palm of his hands and his genitalia. very itchy all over body. has been to a dermatologist, but no help. he is a cll patient. can not figure what is causing the rash.60 years old.[/INST]Hello, Looks like secondary cutaneous changes, manifesting like purpura, vasculitis, exfoliating erythroderma, etc. Avoid taking purine analogs & alkylating agents. Get a follow-up physical examination done by your treating doctor to rule out skin infiltration with beta lymphocyte(Malignant/non-malignant disorder) often seen in CLL patients. Your husbands' treatment will depend upon the type of skin manifestation detected & investigated. It can be harmless(insect bite/allergic rash) but if detected malignant it will require immediate treatment without delay. Hope I have answered your query. Let me know if I can assist you further. Take care Chat Doctor. </s>

<s>[INST]My patient is not conscious, suffered a TIA and is having very high levels of potassium . He has previously suffered stroke and is a known diabetic Type 2 as well as hypertensive. At the moment, the gums and feet are bleeding? Doctors think that this may be kidney failure. I would want to be helped to understand the gravity of the situation.[/INST]Hi, Thanks for posting your query. Your treating doctor is right...your patient is already suffering from diabetes and hyperkalemia (increased potassium) is very common in renal failure. Your patient is unconscious and has gum & feet bleeding, there may be high chances of intracranial bleed making patient unconscious. You should go for CT/ MRI brain to rule out bleed. You should also go for bleeding time, clotting time, prothrombin time to clarify the cause. Yes, your patient is serious and bleeding is not a good sign. You should also go for liver function test, renal function test, complete blood count also. You patient needs intensive care. Take care,</s>

<s>[INST]Hello, My name is Henry, Im having lots of trouble with my mind worrying all the time, making bad decisions, cant keep a job, my marriage is been off because of my problems, cant concentrate, not attentive, not sociable and have no feelings in getting motivated to do tasks. Ive been going to doctors for over 20 yrs and not one of them have done tests. They just guess and say here try this medication, if it soesnt work well try another and another and so on. Been taking Ritalin for 3 yrs, 20mg twice a day. I tell my doctors that if I take 20 mgs 6 of them seperately doing the day I feel absolutely fantastic, Im sociable, more confident, attentive, and make better decisions. but 2 20 mgs a day just dont do it. AT ALL! I take 3 in morning everything is great until 2.5 hours later. THey wear off and Im back to being aweful, So I take 1 for another hour then 1 for another hour and 1 for another hour. That seems to work really good. But that is like overtaking my meds that were prescribed to me. Why cant they just prescribe me 3 40 mgs a day? I want to be better after all these yrs of taking off the wall medicine that dont work. but dont want to over tale whats prescribed to me. Adderal is aweful, and so is dexedrine. Ritalin LA and RA makes me wired and jittery dont work at all. Can someone please after all these yrs help me? In my opinion I need tests run brain and blood work, but havent in 20 yrs had any. I asked them too, but they say no u dont need tests.[/INST]Dear Henry, Thanks for using Chat Doctor. Your doctors are absolutely right in saying that you do not need any tests. At the same time I think you need some behavior therapy to counter your symptoms. It is difficult to predict what is going to work for you, but I guess that even the low dose Ritalin can help you to the large extent if behavior therapy given along with this medication. It is also possible you may not need medication if you get good results with behavior therapy. This is a bitter truth that you need to take Ritalin unless other measures of helping you are not tried with almost seriousness. Thanks</s>

<s>[INST]yes I just recently had an mri don due to job injury about a year ago,it came out normal but im still in pain everyday.My physician says he don t know what it could be,he ordred physical therapy again.im wondering if it has to do with some nerve damage?[/INST]Hi, as mentioned by you the history of your illness, what I can understand is you have a general body pain. Now to understand your pain the MRI was suggested. Apparently, with the grace of God it came normal, and it is good news. Now what needs focus is to understand that due to workstation, there is something called as - Repetitive stress injury. This injury are divided into wide based classification. On a general note when you perform the office work while sitting or standing in a same position for longer hours there is a static contraction in the muscular system and leads to the metabolism of the muscles and early fatigue. Which leads to the pain. To help this issue. You need to perform regular gents body exercises, breathing exercises and meditation. The exercises help improve the cellular metabolism with the help of oxygen assisted by the respiratory exercises. Performing regular exercises will help you further and avoid pain and aches in the future. I have personal experience of dealing with patients with similar complaints and with this protocol of exercises they are helped. RegardsJay In Chat Doctor. </s>

<s>[INST]Hi, I recently had an exterpation of pulp on my top incissor tooth. I am going to have a root canal done on it soon. The dentist said the pain should subside in a day or two and It has now been four days and my tooth is still really painfull. Should I worry?[/INST]Thanks for your query, I have gone through your query. The pain can be because of the remnant infection in the root tip. Nothing to be panic, take a course of antibiotics like amoxicillin and metronidazole for 5 days and analgesics like diclofenac. Later you can get the tooth treated with root canal treatment. Meanwhile get the root canal irrigated or cleaned with saline or HY Chat Doctor. It may take 5 days for the pain to come down. I hope my answer will help you, take care.</s>

<s>[INST]yes please. I have excruciating pain in my top left half of my back and left side of my neck. I have pain all down my left arm and breast . No pain below breast or on right side. I am experiencing intolerable pins and needle type pain from back to finger tips of left hand. The pain goes like a vine shooting down in a spiral feeling motion from my neck back and wrapping around inside my arm. I cant sleep . I am at work and it really hurts. went to ur docs in on Jan 1 they said it was viral from the flu and would go away. I went to my doctor Jan 5 and she said it was "cold " settling in my back. I have Been over my cold so that is wrong. Please help me what do you think is wrong? I am usually healthy and am not overweight.[/INST]Hi, I value your concern regarding the symptoms. I have gone through your symptoms, and in my opinion the type of pain you are telling could stem from a prolapsed disc in your neck, you need to get sure of that, and will need an MRI to confirm that Hope this answers your question. If you have additional questions or follow-up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health. Special note-Any medication prescribed needs to be taken after consultation with your personal doctor only.</s>

<s>[INST]hi, ive had swollen glands for three months now, i have a red rash on the roof of my month and blister like feelings in my throat, i doesn t hurt when i swallow but my glands hurt and i have a stiff neck all the time. i get moments when i feel really tired and go hot and cold within minutes? I have had a course of anti biotics which didn t work and a course of tablets for oral thrust which didnt do anything. I have been transferred to a ent surgeon, should i be worried debi[/INST]Thanks for your query, I have gone through your query. The swollen glands with rashes on the roof of the mouth can be because of the allergic dermatitis or the herpes zoster viral infection, or it can an erosive lichen plans. Consult an oral physician immediately and get it evaluated. If I am your treating doctor, I would suggest you to get a clonidine blue test done and a biopsy of the lesion to confirm the diagnosis. Once the diagnosis is confirmed we can treat accordingly. If it is a herpetic infection ulcer you can take topical anesthetic and analgesics like 2%lignocaine and choline salicylate gel (Anabel gel) apply 3-4 times daily before food along with a course of antiviral Chat Doctor. If is a lichen plans or allergic dermatitis you can take topical anesthetic and analgesics like 2%lignocaine and choline salicylate gel (Anabel gel) apply 3-4 times daily before food and topical steroid like triamcinolone acetone 0.1% 4-5times daily after food. I hope my answer will help you, take care.</s>

<s>[INST]Hi my boyfriend has this cough every so often that sends off a bad smell and I don t think he notices it but to me it s terrible. He smokes and has for years but he didn t seem to get this smell until this past winter so I don t know if it has to do with his smoking or something else. Also when he does cough he sometimes has big chunks of mucus come up. He thinks it s nothing but I m worried it s serious or could become something serious.[/INST]Thanks for your question on Chat Doctor. I can understand your boyfriends situation and problem. Since he is a chronic smoker, possibility of either bronchitis or lung infection is high. 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. It will also tell you about severity of the disease and treatment of bronchitis is based on severity only. He may need antibiotics, antihistamines, inhaled bronchodilators and inhaled corticosteroid (ICS). Smoking cessation is must for him. So consult pulmonologist and discuss all these. Hope I have solved your query. Wishing good health health to your boyfriend. Thanks.</s>

<s>[INST]`I have been on Ultram for years prescribed by a specialist in fiblermylasia. Recently got a new regular MD who put me on 3/325 hydrocodine ,6 a day plus a fentenal patch 25 mg. I m 72 so my arthritis has gotten unbearable so she had me go to a pain specialist who raised my fentenal to 50 mg. and put a shot of cortison in my lower back. After the shot a lady pain specialist swoops in to tell me my hydro is now down to 3 aday and I no longer will be on the ultram. I am dumbfounded and not sure if she is right. Isn t Ultram for fibermylasia? I still have low pain so I wonder if that was right for me.[/INST]Hi, thank-you for providing the brief history of you. As you have Fibromyalgia, this condition called fibromyalgia is the inflammation of the fibers of the muscles. Muscle contains numerous muscle fibers which acts as a mechanism for the contraction of the muscle. And inflammation in the fibers will lead to pain as the muscle gets to fatigue faster. Also, medicine has a limitation to control the inflammation as this is deep inside the muscle fibers and fibers are numerous.in my clinical practice most patients with fibromyalgia are referred to physical therapy as improving the metabolism helps to reduce the pain. Also, doing breathing exercises will help improve the oxygen carrying blood cells and will improve the endurance and avoid the fatigue to occurs soon in the fibers. RegardsJay In Chat Doctor. </s>

<s>[INST]I wascdiagnosid with Pneumonia and hospitalized approximately 5 days ago by emergency Ct scan with contrast. I have been treated with antioboitisa I I , po pain medicine and breathing tx since. Levaquin and zosyn IV was started right now. I have been taking Percocet for the pain. I called my Doctor and trying to get some answers and she said she would bet it was exclusively pneumonia. Now some of the other doctors are mumbling about cancer? When I get better, I should return in 5 weeks for a repeat Ct. They are playing with my LIFE now. Please, any guidance would be welcome. Thank you.[/INST]Thanks for your question on Chat Doctor. I can understand your concern. If CT scan is suggestive of pneumonia than no need to worry much for cancer. You are taking antibiotic treatment. So wait for its response. Usually improvement is expected after 10-15 days of treatment. And radiological resolution takes almost 1 month. So in my opinion, you should get done repeat CT scan after 1 month. If opacities are still persisting than get done broncos copy and BAD (bronchoalveolar lavage) analysis to rule out cancer. If you are smoker than quit smoking as soon as possible. Hope I have solved your query. Wish you good health. Thanks.</s>

<s>[INST]Hello Im a male 44 years old and I have pains on my left side of my penis when I have sex. And I use to take a 10 milligrams of cialisis and now it takes longer to harden my health is good. I Not fat. I take one a week so I can explore sex more with my wife but not Im nervous could I have a cogged arterie?[/INST]Hello I share your concern This pain might be caused by dialysis (tadalafil) or injury due to lack of lubricationCialisis increases blood flow to penis and makes it hard, sometimes it may cause pain in penis due to vasodilation of veins in penis shaft and corporal. In my opinion you should use lubricants during sex to avoid injury caused by friction can take ibuprofen for pain in penis if it is unbearable or reduce the dose of dialysis. Hope this answers your question, and you will find my response informative and helpful. Please feel free to ask for more queries. Wishing you good healthRegards</s>

<s>[INST]Hello Sir, My 6 & 1/2 yrs. doughter having a small boil at the start of nose and it causes soiling on the face (i.e. under eyes, throat & chick). Yesterday Doctor prescribed AZAX 250 (Azithromycine), but the problem is increased. I contacted another Doctor and he has suggested AUGMENTIN 375 3 TAB daily. Is it OK?[/INST]Hi, It seems that there might be having soft tissue infection leading to induration, swelling and pain. Azithromicine is good antibiotic but any antibiotic including Augmenting takes some time to start its action. So wait for 2-3 days, its effect will start, and she will feel good. Remain follow up with your doctor as having sever infection at this site might cause some problem. Give her anti-inflammatory medicine for 2-3 days. Ok and take care.</s>

<s>[INST]hello sir is there any medicine to increase sperm count and increase the sperm motility . and i m suffering from necrospermia. in the span of 4 months my sperm count have been decreased to 20million/ml from 68 million/ml. how to regain my original sperm count and motility? please provide the best suitable medicine thanks santosh[/INST]HelloThanks for your query, based on the facts that you have posted it appears that you have Necrozoospermia. Necrospermia is mainly due to either presence of infection in seminal vesicle or prostate or due to presence of anti sperm antibody which kill the sperms. There are no medicines to be proved effective to treat Necrozoospermia. And to improve sperm count. Please consult qualified infertility specialist for further evaluation to find out the cause of Necrozoospermia and or else to explore possibility of conceiving with the help of newly assisted reproductive techniques like Sperm concentration, .IVF or CSI. Chat Doctor. </s>

<s>[INST]my chest feel like a heavy brick is sitting on it after I eat. What is causing this? I do not feel sick at my stomach and I have no history of any illnesses. I have always been very healthy. I am 51 years old, I m at a healthy weight. This has just started happening the past few weeks.[/INST]Hello thank you for trusting ChatDoctorDear in chest many part sun your cheat. The pain may be arising from esophagus, heart,lungs, muscles and bronchioles. If it is associated with food may be related to stomach and esophagus. Gastritis and gastroesophageal reflex may present like tightness and burning in chest and abdomen. If it is associated with cough, douran probably it is arising from lungs or respiratory bronchioles. If it us associated with palpitations, chest pain, giddiness it may be associated with heart. sometimes muscular pain may cause chest pain. But we need complete evaluation and follow up for this. But don't neglect the pain first we have to rule out pain not arising from heart. Then we treat as non-cardiac pain no worries. Please consult your doctor he will examine and treat you accordingly. Take care</s>

<s>[INST]Hello Doctor ..... My daughter is 4 months old. She s been passing semi solid motion 6-7 times per day from past 3-4 days, but from today morning she s passing loose stools from morning she has passed 3 times . Suggest me some remedies. Thank u Doctor [ SALLY ].[/INST]Hi... Thank you for consulting in Chat Doctor. It seems your kid is having viral diarrhea. Once it starts it will take 5-7 days to completely get better. Unless the kids having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry. There is no need to use antibiotics unless there is blood in the motion. Antibiotics might worsen if unnecessarily used causing antibiotic associated diarrhea. I suggest you use zinc supplements (Z&D Chat Doctor. </s>

<s>[INST]I injured my knee on July 2, and now there is some fluid on the anterior part of my knee. It aches a little when I am on my feet for long periods of time. Is there any way to treat it w/o going to the dr s office? I have been wrapping it and taking ibruprofen[/INST]You can try using hot pack for 10 to 15 minutes and post that apply some pain relieving ointment repeat this two to three times a day. As well do simple knee exercise like in a long sitting position legal straight press knee down or tighten your knee and front thigh muscles hold for 5 seconds and relax. If it relieves with this great but of not then you need to visit doctor for proper treatment management. I Hope it was helpful to you. Take care</s>

<s>[INST]Went to a thai massage parlour. Got massage on genitals. While massaging near groin, got a cut as long as 2cm on skin. She used massage oil. She did repeeatedly massage the wound area and had fingernail contact on it few times again. Is there anything to worry about?[/INST]Hi there, and thank you for your question. I appreciate your concern regarding this matter and I'll try to help where I can. If one sustains a superficial scratch on the skin, then you should look out for signs of infection at around the third day after the injury. These signs include redness around the site of the wound, pus discharging from the wound itself or generalized fever experienced by the patient. If you start to notice these signs, then I would suggest that you see your doctor as soon as you can so that they may prescribe the appropriate treatment for this issue. In order to prevent an infection from occurring you can continue with the following care. You can clean the wound with a saline solution (salt water) 3 times a day until the wound has made a scab over it. You can then let the area granulate on its own. I hope this helps and good luck.</s>

<s>[INST]hi, im a 13 year old boy. I was curious about circumcision. My penis is 3 inches when flaccid but has the foreskin covering it. I read about the benefits of it and was interested, I can pull back the foreskin but not all the way. i heard that you can contract diseases from not having an uncircumcised penis and need advice.[/INST]Hi, I understand your concerns. Clinical trials have shown that circumcision benefits are notable. It reduces HIV infection risk for about 50-60%. About 30 % risk of contacting HPV and herpes are reduced, notorious causes of penile carcinoma. The benefits of preventing urinary tract infections and sexually transmitted diseases after vaginal sex are now documented. You should consult your local surgeon for better advice. Hope this answers your question. If you have additional questions or follow-up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health</s>

<s>[INST]My partner rubbed the tip of his penis inside my vaginal lips, but there was no penetration. Im almost certain there was pre-ejaculation and I too was very wet. He did not ejaculate anywhere near my vagina, but on his body. He wiped off the semen from his penis with a dry tissue. Would there be residual semen on his penis that could cause pregnancy if we repeated the same act later in the day, no penetration but rubbing around the vagina? Could I become pregnant from the first action described?[/INST]Hello, In above type of sexual activity, chance of being pregnant is quite less. Though it depends on fertile days or ovulation time. Precum or ejaculatory fluid on tip of penis contains small amount of sperm and may cause pregnancy in some percentage of women. Here, you need to wait for next coming period. If it is delayed more than 7 days, you need to undergo one home pregnancy test to be sure. Practice safe sex in the future. Good luck.</s>

<s>[INST]Hello doctor. I had 1 tetanus shot & 3 anti rabies vaccine. my last was in june 30. This wass the recommended shot for me as suggested by the doctor. But one of my grandmss cat bit me last july 3. do i need to get vaccinated again? pls help. Thank you.[/INST]Hello, Welcome to Chat Doctor, As you was bitten by a dog previously for which your doctor has advised the shots of antirabies vaccine and a shot of tetanus injection. As you were bitten by cat after a period of one month according to WHO categories you will be identified as Re-Exposures. Re-Exposures should receive two doses of vaccine on days 0 and 3. Even it is a Cat III bite only two doses of antirabies vaccines is sufficient. So I would suggest you to take two doses of antirabies vaccine on days 0 and 3 over the shoulder. Thank you.</s>

<s>[INST]Im 15, Im shivering cold. I had 7 blankets on last night but I was still freezing. I have asthma. I went to my doctor to talk to him about my coughing and breathing troubles recently. My body aches in my elbows, back, wrists, ankle, head, and chest. I felt to weak to move this morning, nauseated, and Ive been out of energy for 3 weeks now. My asthma has been acting up every night for the past 3 weeks. Last week I was literally unable to breathe because of how tight my chest was. My asthma is doing fine now, but I just want to feel better. I have a barky loud cough that annoys my parents and comes often. Ive been sick for 3 weeks.[/INST]Hi, Welcome to Chat Doctor, Your cold, wheezing, cough could be due to upper respiratory infection or allergic rhinitis or bronchitis etc. You should do some routine blood works and X-ray chest to rule out infection in lung. He will require oral antibiotics with antipyretic, antihistamines in oral formulations. Now, if he has been diagnosed with asthma already then he would require bronchodilators like beta agonists and anticholinergics in MDI or rota haler. In addition, antihistamines(like cert zine or Allegra) and mast cell stabilizers are also had a useful in the treatment of asthma but for all this treatment. With all above medication you will feel better in 2 to 3 days for which you need to consult physician or pulmonologist who will guide you further.</s>

<s>[INST]Hello doctor, i am a male,22yrs,172cms,64kg.Since the past 6 days i have both typhoid and malaria(plasmodium vivax),as suggested by blood test.No vomiting and i also have been attending half-day college as i am completing great in the morning,but only fell low at night.Please suggest.[/INST]Hi thanks for contacting Chat Doctor. Note you have both typhoid and P.vi vex malaria..... Do you have consulted physician for that.??? For malaria take chloroquine or alternate Chat Doctor. For typhoid take definite 200 mg tablet for 10 days...Meanwhile, take care of following... Take soft and bland diet. Better is to use semisolid food and fruit juice more. Take protein diet like egg, pulse, milk etc. Avoid high fiber food.... Avoid excess fried and fatty food... Non veg and junk food avoided....</s>

<s>[INST]Okay, so my friends were smoking pot on tuesday(four days ago) and I told them I didn t want to get high, I did take one hit even though I do not like weed at all. They hotboxed the garage and ever since then I ve had severe bloating and constipation. My skin is breaking out extremely bad all over, and I have a lump in my armpit. I haven t been able to eat much, and when I do it seems to make things worse. Even though I should have lost weight since I am not eating, it says I have gained!! What is going on??[/INST]Hi, dairy have gone through your question. I can understand your concern. Painful lump in armpit can be enlarged axillary lymph node. It may be due to some reactive hyperplasia, tuberculosis or lymphoma. You should go for complete blood count, erythrocytes sedimentation rate and biopsy of that lump. It will give you exact diagnosis. 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]Hello, do you know when you sleep on your hand and it you cant feel it for awhile?, that what my whole body feels like, I take Zoloft, trazdone(sleeping aid) and lamactal, I dont know how to spell it. I take them because I supposably have anxiety problems, but I dont know, im scared and I need help badly[/INST]Hi, Thank you for posting your query. I have noted your symptoms, and your current medications. I feel you are having adverse effects due to your medications. Please discuss with your psychiatrist whether you really need so many of these medications. In addition, you should get your vitamin B12 level checked up, as any deficiency could cause these symptoms. I hope my answer helps. Please get back if you have any follow-up queries or if you require any additional information. Wishing you good health, Chat Doctor. Ly/</s>

<s>[INST]Last week Saturday I was diagnosed to have typhoid fever. Given cipro which I should finish tomorrow. I have been feeling great but yesternight I could not sleep due to a nausea feeling. Should I still be feeling this way when am almost through with drugs.[/INST]Dear Friend. Welcome to Chat Doctor. I am Chat Doctor. I have read your query in detail. Furthermore, I understand your concern. Nausea can occur on taking antibiotics like Ciprofloxacin due to Gastric upset. So, I would advise you to follow:11. To take Chat Doctor. 2. To take soft bland diet.3. Don't smoke or consume alcohol in case you do. This is my best advice for you based on available details. If you have any further query please ask me. Stay Healthy. ChatDoctor, MD</s>

<s>[INST]We have an18 month old granddaughter that seems to have ptosis, and then occasionally throws up without showing any sign of discomfort. The ptosis is being followed up on. First appointment in 3 weeks. The throwing up daily is disturbing. Any advice or explanation would be appreciated.[/INST]Hi...what you are quoting is exactly called - effortless vomiting in medical language and this usually signifies a gastroesophageal reflux. Your granddaughter may need - 1. Antireflux therapy - Proton pump inhibitors + antiemetics2. Always make her lie down in a propped up position - as in the care seat. She should not be sleeping completely flatly.3. Avoid heavy feeding and feeding more times and in small liquors. If this doesn't work then she may need expert gastroenterology consultation. Regards - </s>

<s>[INST]Hi,I have rashes keep coming with itching and sometimes swelled rashes also.I got my blood tested. I have high ESR of 28 and eosinophils count of 8. Please suggest me what can be the problem. Is it some infection?Also sometimes while I put my foot on the ground, I feel pain.Is it only some kind of allergic infection or do I have lymphosite also?Regards,BG[/INST]Hello, Welcome to Chat Doctor It seems like you have an allergic rash called urticaria. ESR of 28 is alright. Eosinophils can increase to 8 in an allergic situation including urticaria. Usually urticaria is caused by a particular food that you ate, or medicines, or infection, intestinal worms, insect bites kindly consult a dermatologist and start taking antihistamines. He will help you in identifying the trigger Hope this helpedTake care</s>

<s>[INST]Hi, I had a breast reduction 11 days ago, and Im feeling pretty good. I havent taken any meds in about 3 days and Im not in much pain at all. Ive been showering and washing my incisions and putting antibacterial ointment on them as told by my doctor. So today when I was standing and cleaning off my incisions to go get my stitches removed, I became very lightheaded and started to blackout. I sat down and in a couple minutes..I was fine.. any ideas?[/INST]Hello dear, Thank you for your contact to Chat Doctor. I read and understand your concern. I am Chat Doctor answering your concern. It is a hypotension that has caused you make this. Nothing to worry. It is common in some operative patients. As during the operation our body system becomes somewhat weak. So when you remain standing for prolong period, or you can stand after prolong sitting such episode can occur. But it is nothing to worry in single such episode. But if it recur on second or third time than you have to check your blood pressure. Taking an appropriate treatment can cure your such an attack. Please take enough sleep and forget the episode that has occurred with you. This will help cure your problems. I will be happy to answer your further concern on bit.ly/ Chat Doctor. Thank you, ChatDoctorInfectious diseases specialist, ChatDoctor.</s>

<s>[INST]Hi I am a patient with ChatDoctor, no SAM , no LVOT grad, taking angizem DP 120 since 1 yr 6 months, but since then my liver started getting fatty and now it is grade 2 Q1. Is ditiazem hydrochloride has any role for fatty liver. Q2. Can it be replaced by any other medicines like beta -blocker. kindly give appointment at your residence if necessary.[/INST]Welcome to Chat Doctor! I appreciate your concern towards the safety of Diltiazem. Age, gender and the indication for Diltiazem not mentioned!!! Diltiazem belongs to the calcium channel blocker group of Chat Doctor. It is used to treat high BP and angina (heart pain) caused by spasms in the blood vessels that supply the heart. The most common side effects caused by Diltiazem include: Headache, ankle edema, constipation, hypotension flushing, and it may also cause fatty liver (stenosis). In view of the last side effect that you appear to be suffering from, you can consult your doctor to use the alternate </s>

<s>[INST]i had cabg two months ago. for the past one month i am having dry cough with frothy white sputum. I have a little esonophils. the cough is not continuous, comes once in a while but lasts for about 15 seconds and i spit white frothy saliva. can you suggest a remedy[/INST]Thanks for your question on Chat Doctor. I can understand your concern. Cough with frothy saliva in CABG (Coronary artery bypass grafting) patient can be due to heart failure. Actually heart failure causes pulmonary edema. And this can cause cough with frothy sputum. You are also having eosinophilic (high eosinophil count). It is seen is allergic diseases liked asthma. This can also cause cough. So better to consult doctor and get done 1. ECG and 2d echo to rule out heart failure. 2. PUT (pulmonary function test) to rule out asthma. Don't worry, with appropriate treatment, you will be alright. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.</s>

<s>[INST]what happens if some drinks 250 ml of phenyl and after 15 min had 3 glasses of water mixed with 12 spoons of salt to cause intentional vomitting and vomits several times instantly and can see traces of phenyl and food in the vomit .After 24 hours patient has symptoms of some sort of weight on the chest and have in respiratory tract with mild difficulty in respiration. Patient passed loose stool after half an hour of consumption .patient cant go to the hospital for next 8 to 10 hrs. please advice[/INST]Thanks for your question on Chat Doctor. I can understand your concern. Phenol is irritant to mucous membrane. So on ingestion, it is likely to damage esophageal mucosa. While ingestion, some Phenol might have aspirated in trachea and lungs. So Phenol ingestion is likely to damage esophageal and tracheal mucosa. Damage to esophageal mucosa causes ulceration and burning chest pain. Damage today respiratory mucosa will cause inflammation of the airways and bronchitis. This bronchitis is the likely cause for his breathing difficulty. Usually these all are self limiting in 1-2 days. Ask patient to Chat Doctor. Avoid hot and spicy food. Take pantoprazole tablet on empty stomach. He will mostly improve with all these. If breathlessness worsens or chest pain increases with vomiting then immediately consult doctor. Hope I have solved your query. I will be happy to help you further. Wishing good health to your patient. Thanks.</s>

<s>[INST]I recently took Clomid to try to get pregnant. I went in for a follicle scan and my dr said I had one good follicle but it was still too small (15mm) So he had me come back three days later. After two days I did an OPK and it read positive. I went in for a follicle scan today and he said that my follicle must have ruptured on its own. My husband and I had intercourse last night. If my follicle ruptured yesterday, do I still have a chance of getting pregnant? My doctor told me to have intercourse tonight and tomorrow night also? Is that correct?[/INST]Hi, Follicle size of 18-21 mm release the best quality egg and high chance of pregnancy. Egg will live for 24 hours after rupturing. So you have to do sex before 24 hours and 24 to 72 hours after rupture of follicle. Your follicle has been ruptured, and you had sex yesterday, so there is chance of pregnancy. Continue to do sex next 1-3 days. You can also take progesterone pill after ovulation. It will make uterine environment favorable for implantation and support pregnancy. You can also use acre to support pregnancy. Avoid stress, take healthy diet, and Chat Doctor. Hope this may help you. Contact further if follow up needed. Best regards,</s>

<s>[INST]I recently was diagnosed with pneumonia on my right side and thought I was getting better. The peoblem I have now is severe coughing to the point of gagging with no mucus coming up and severe tiredness and dizziness. My question is what might be going on?[/INST]Hello, Welcome to Chat Doctor, Pneumonia is condition in which there will be infection of the lung parenchymal by the microorganisms. As you are having pneumonia of the right lung, because of which you are getting these symptoms. As you have been diagnosed to have pneumonia and I hope you are on treatment. A course of antibiotics will improve the condition by acting on the microorganisms. I would suggest you to take a syrup for Chat Doctor. Thank you.</s>

<s>[INST]My baby is 1 year and 4 months , she suddenly gad fever yesterday fo bi reason at all, il visit her doctor this morning and dine urine test m the result is pus cells 3-5..is this very high for a child? The doctorvgave an antibiotics,,thank u, please give me advise[/INST]Welcome to the ChatDoctorThere is no need to be worried about 3-5 pus cells on urine examination. It needs no treatment unless and until a child is symptomatic. I would recommend you to go for urine culture and sensitivity report before starting antibiotics as it is a more definitive test for urinary tract infections. As such, most common reason for fever in this age is self limiting viral infections which need just symptomatic treatment like acetaminophen for fever. Hopefully this will help you. I would be glad to help you for any further child health related query. Take care</s>

<s>[INST]I have Trigeminal Neuralgia and I have had it for 8 years and through those years I have tried many drugs for seizures which did not work. I have had MRI s and nothing has really developed that I can say it has because never saw either scary. Had the Gamma Knife procedure done July 2016, that didn t work. Had a drug reaction , broke out in a full body rash, got meds, lost 20lbs, could not eat because the pain was so bad I had to eat out of one side of my mouth from a cup folded in half to make a funnel to pour in the liquid drink I drank this way for 3meals a day for 30 days. .[/INST]Hi, There are many medications that are not antiseizure medications which can be useful against TN such as Tricyclics (nortriptyline, amitriptyline, desipramine, duloxetine, migraine), muscle relaxants (Baclofen, Tizanidine), and calcium channel blockers (Verapamil, Diltiazem, Expletive). TN is a very challenging problem to resolve. I'm curious to know what they actually gamma knifed and hope that doesn't result in long-term chronic central pain syn Chat Doctor. No matter where in the brain they ablate nor for what reason. Hope I have answered your query. Let me know if I can assist you further.</s>

<s>[INST]4 days ago i woke in the morning and coughed up lots of fresh blood - went to gp who prescribed antibiotics. today i had another coughing fit and coughed up a fleshy lump which looks like it has torn off of somewhere. my throat feels better and my cough has reduced but im worried[/INST]Hi welcome to the Chat Doctor First it should be confirmed that blood is present in sputum and not in vomit... Bloody sputum cough can be from bronchitis, pneumonia consolidation or other respiratory problem It is better to consult pulmonologist for examination.... -Auscultation -CBC -x-ray chest -sputum examination only if needed According to cause specific treatment given Mostly antibiotic is sufficient for bronchitis If report suggestive allergic cough than levocetrizine or fexofenedine prescribed Take care Avoid smoking if habit Keep environment dust exposure minimum Hope I have solved your query</s>

<s>[INST]My husband had to undergo medical examinations required for their job onboard...he was diagnosed to have 108 sgpt level the normal should be 80 what should be the best thing to do for him to reach the normal level required for the test?Despite the exercise and strict diet he did accompanied by medication prescribed by the attending physician because this was already the 2nd time he went for a test the first one was pending he did have a 140 sgpt level...Could you please give me any possible things to do to lessen it in just 3 days he will be back again ob Tuesday for a test..thanks looking forward for an answer soon..God bless.[/INST]Hello! Thank you for the query. Unfortunately it is impossible to make Sept level normal in just 3 days. SGPT is a liver enzyme which gets elevated when some liver cells get damaged. And it takes about a month for liver cells to regenerate. So it takes at least a month to decrease SGPT level. To do that your husband should modify his diet (avoid fatty foods, spicy foods, fried foods), avoid alcohol intake and do not take painkillers (like Acetaminophen). Hope this will help. Regards.</s>

<s>[INST]sever abdominal pains I am having very server abdominal pain that radiate through my rectum into my lower back and its mad worse by sitting or number 2 i have to lay down on my back to get relief i have this for years but no anwser it randomly happens twice a month 12ultrasound s and 2 xray s later no anwser just prescription for antacids[/INST]Hi ! Good afternoon. I am Chat Doctor answering your query. From your history, and without any physical findings by your treating doctor and normal reports of all the investigations, it seems you are suffering from a condition Nostalgia fugal, a benign condition, but quite debilitating as described by you. This is not an infrequent condition, and the treatment is variable starting from anti spasmodic, calcium channel blocking agents to sub lingual nitrite during the acute episode. 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]I am on reclipsen, I have been taking it for about two years now. I had breakthrough bleeding occasionally, when I first started but not since then. Recently (I do apologize, for oversharing but then again, Im sure youve heard everything) I had unprotected sex with someone, while I was having the very end of my period. I usually last around days with decent flow, then two brownish old blood days. this was on the sixth day, my first brownish day. I trust this person, am not concerned about stds at all, but he was, well, a bit rough. Hes quite well endowed... I began bleeding again, bright red, but a tampon lasted all day. This happened on sunday the 21st, I am still bleeding. Not heavily, but the fact that it is at all, worries me. Typically when I have my regular period I change my tampon every two hours or so. I had missed a couple pills on my card as well, on the third week of the last pack, when I called to ask what to do, the nurse said take my missed pills (there were only two I missed,) and start a new pack, to not take the last row (the fakes) So, should I be concerned? Thank you for your time!!! -Ashley[/INST]Hello, You may not have to be worried about pregnancy, as you had sex during the menstrual period. During this period the chances of conception are quite low. The bleeding which is still continued after about 24-25 days is not normal. You should have undergone pelvic exam and may be other investigations like Ultrasonography. Keep taking your medicines and get checkup as soon as possible. Thanks being frank. Good luck. Take care</s>

<s>[INST]I have a very very very sharp pain down my right leg when I stand up and start to walk, this started with a very sharp pain in my right upper butt yesterday, I sett a lot and I think its my sciatic nerve ???. I have been on my back all day , icing 1/2/hour then 1/2 no ice and every four hours i take 4 ibuprofen 200mg. I have to drive tomorrow can I find a stretching move that would help.[/INST]Hello, I have studied your case. Usually nerve compression can't be seen on x-ray you may need MRI for this. If there is any nerve compression then that may need specific treatment. I will advise you to do MRI instill time, avoid lifting weights, Sit with support to back. You can consult physiotherapist for help. Physiotherapy like ultrasound and inferential therapy will give quick relief. Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take care.</s>

<s>[INST]I have a 14 year old daughter who has been having high fever for one week, with headaches, feeling tired, and feeling bloated after eating about 1/2 portion of what she usually eats. X-ray normal. Doctors say to wait two more days to start doing blood tests as they believe it is a virus.[/INST]Hi, Since the child is having fever for one week duration it is better not to delay blood tests any longer. In your description you haven't mentioned the other symptoms' child is having like, cough sore throat, runny nose. Does the child have diarrhea? Did the symptoms' severity reduce with time or did it worsen? With viral fever usually symptoms reduces after day 5, it is most likely a viral fever, but it is better always to do your blood test and exclude bacterial infections or other serious infections. Hope I have answered your query. Let me know if I can assist you further.</s>

<s>[INST]I have a rice sized, hard bump behind my lower left ear directly behind the lower ear lobe that seemed to appear over the last 4 months and wont go away. It feels it is sometimes sending an infrequent pain down the side of my next that lasts for 2 seconds.[/INST]Hi. Thanks for your query. Read and understood your history of a small rice sized hard lump behind the ear that sometimes cause 2 second sharp pain. The possibilities are:GranumolaNeurofibromaCyst on a small sensory nerveSince it is so small the ultimate treatment would be to get it excised under local anesthesia and send for histopathology examination to get a final diagnosis. Also watch for similar lumps anywhere else in the body.</s>

<s>[INST]Im 27 years old and for the last few years Ive noticed a slight pain that comes and goes on my left side. Sometimes I get it on my right side but not as often. A few days ago I noticed a small lump on my left side. Its not noticeable unless pushed on in the exact location of the lump. I ve had mild persistent pain as well. I ve also been having a few more headaches than usual. Should I be worried?[/INST]Dear, Thanks for the query to Chat Doctor. I studied your query and understood your health concerns. Remedy and cause-of your problem-In my opinion your painful lump on left side with frequent headache -indicates-a-High BP with Anxiety neurosis- which is caused due to lump on the left side of your chest. I would ask you to consult ER Surgeon and Physician. I suggest you following -a-Not to Worry but act fast with Surgeon and Physician.b-Revert to your doctor on this advise-who would help you. This would help you to resolve your query. So act fast and investigate it. Welcome for any further query in this regard. Write review ASAP, with strong recommendations for Me and Chat Doctor to benefit old and new patients. Have a good day. With Chat Doctor. N.</s>

<s>[INST]my 13 yr old daughter has had pain in her right side for over a week. when she eats seems to worsen, and when walking alot pain gets worse. they had ran test to check appendix, kidneys gulbladder and tons of bloodwork everything came back good but she is still in alot of pain. what can be the cause of it?[/INST]Hi. Thanks for your query. The diagnosis of a pain in a girl of 13 is sometimes difficult and not easy to be accepted by the parents. < test to check appendix, kidneys gallbladder and tons of blood-work everything came back good> indicates there may not be an organic / bodily problem. This may be IBS= irritable bowel syn Chat Doctor. Also get colonoscopy, CT scan of the abdomen done. A trial of anti-psychotic medicines is worth if all the tests are negative.</s>

<s>[INST]my mom is an alcoholic and diebetic and used to drink really heavily for years. SHe went to treatment several years ago and got healthy. Well now she has started drinking again. She has had 3 or 4 episodes of random swelling of her lips neck or tounge, what does that mean? should i be worried? is that a sign of liver diease?[/INST]HiT hanks for writing to Chat Doctor Usually swelling of lips, tongue and neck and seen in allergic conditions (angio-oedema). In liver disease there could be parotid gland (salivary gland) swelling. The swelling if occurs as a part of whole body edema then it could be due to liver disease with hypoproteinemia and fluid retention. Anyway get checked with a gastroenterologist. It is better to avoid alcohol as this would further damage the physical, mental and social health. Get LFT (liver function tests) Longshanks and regards</s>

<s>[INST]Hi i got my ultrasound today and was diagnosed to have enlarged liver with diffuse increase in parenchymal echopatttern. No discrete mass seen. The intrahepatic ducts are well defined and not dilated. Impression: Hepatomegaly with fatty infiltration. Iam nor smoking nor taking any alcoholic drinks, but was diagnosed to have hepa b in 1992. What should i do now. thanks[/INST]Hi, Thanks for writing in. Your liver ultrasound report shows an enlarged liver with fatty changes. You might be having non-alcoholic fatty liver. Research shows that the components of metabolic syn Chat Doctor. The presence of hepatic fibrosis seems to be associated with known host and viral factors as well as the presence of abdominal obesity. You must get your scan and blood workup done annually or once in two years.</s>

<s>[INST]My 14 year old recently had his annual physical with the pediatrician. After the regular checkup, the doctor mentioned that my child was virtually done growing based on his stage of puberty. A few weeks later, at an orthodontic appointment, his ortho took a hand and wrist x-ray film. His estimate was for two to four years more growth based on an examination of his growth plates. We are getting two different opinions, here. Obviously, growth is difficult to predict, however, I am curious which analysis is typically more accurate: puberty stage or growth plate evaluation? Thank you.[/INST]Brief answer:Growth plate evaluation is more reliable. Detailed answer:Hi, welcome to Chat Doctor. Growth plate evaluation is reliable method of predicting growth in a child. Growth plate evaluation exactly tells that is there any chance of more growth or increase in height. At 14 year of age in boys pubertal changes occurs and there is possibility of growth for 3 to 4 years. I hope this has helped you. Wishing your child good health. Take care. Regards: Chat Doctor. </s>

<s>[INST]I just had a baby a little over 8 weeks ago. My husband and I had a few oops and I was worried about being pregnant so I decided to test. I do not know for sure if I ovulated but I have not had my post postpartum menstrual cycle. I tested on Monday it came back negative, tested again on Tuesday and got a faint . I called my dr office and was instructed to go in for a blood test. It came back negative, the test given was a "Yes/No" blood test not a beta. It came back negative. Could the test be incorrectly negative? Or possibly a false positive? Does a diuretic affect pregnancy test results? I took a diuretic the day before would that affect my results on the home pregnancy test or the blood test?[/INST]Hi there, please don't panic. Usually, diuretics lead to increase urine Formation. And dilution of the urine. This might lead to false negative results. If you have history of regular cycles and also there is history of unprotected sex act on and around the days of ovulation, then you need to rule out pregnancy. If urine pregnancy test is not predictive, then please get blood beta Chat Doctor test done. Results above 25 confirms the pregnancy and results below 5 rule out the pregnancy. I will suggest you to get proper sex counselling done. This will help to prevent unwanted pregnancy and STDs. I hope this answer helps you. Thanks. </s>

<s>[INST]Ive recently (4 weeks ago) had a corenectomy of my wisdom. I needed this because my roots are wrapped around the nerve, and I had an infection.The Dr. put me on Vicodin and Penecillin. I used all of my antibiotics, and felt okay for a little while. The surgery is not yet fully healed. I still have a small whole that needs to close. Now, the infection has returned. I was thinking its because food might be getting in that little whole from the surgery that hasnt healed. My Dr. thinks it might be an infection in the roots, in which case the chance antibiotics will work is small. He recommends going back in and removing the roots. However, due to their placement, there is a risk that I will have pain and numbness on my lower lip for remainder of my life. I really dont any more surgery. I leave for Africa in two weeks for vacation. Will the amoxicyllin work or should I get the second surgery to remove the roots and run the risk?[/INST]Hi, Thanks for asking the query, According to your clinical history I suppose that the Dentist had performed a carpectomy of your wisdom tooth as your tooth was in proximity of nerves to prevent any complications. I would suggest you to consult the Dentist and get the antibiotics and analgesics prescribed, take lukewarm saline gargles and antiseptic mouthwash rinses. If this does not subside your pain you need to get an OPG radiograph done to determine the exact cause of pain and the treatment plan. Hope this helps out. Regards.</s>

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

<s>[INST]Hello Sir , I am 32 years old 5ft11 and weigh 90 kg.I am gyming from quite some time(5 Day s a Week ) and my instructor has suggested me to take Evion,Celin,B complex & Maxepa tablets Daily One Tab. Aslo Suggested to Eat 7 Eggs in a Day. Is it safe to use them on daily basis? and is these any Side Effect of Eating 7/8 Eggs in a Day ? Regards, NS[/INST]Hi, Evion, Colin, B complex and Maxima tablets, daily one can be taken. Being vitamin supplements, they do not cause any adverse effects. Raw eggs all have the same benefits as cooked eggs. However, protein absorption is lower from raw eggs, and the uptake of biotin may be prevented. Most concerning is the small risk of raw eggs contaminated with bacteria leading to Salmonella infection. Buying pasteurized eggs will lower your risk of infection. Raw or cooked eggs can be consumed. In case of more than 3 eggs, boiled egg white can be consumed. Hope I have answered your query. Let me know if I can assist you further. </s>

<s>[INST]Hello Sir, My name is Jaya Prakash, I am working as Computer Operator. For the Past 6 months I had a severe back pain (It hurts more when sneeze or cough). I had gone with several treatments still I had the problem. Recently, I done with M.R.I. diagnosis. the report is as follows:- 1. Loss of lumbar Lordosis. 2. Disc bulge noted at L4-L5 level causing compression over thecal sac and bilateral neural foramina narrowing. 3. Earily disc proplase with annular tear noted at L5-S1 level causing compression over thecal sac and bilateral neural foramina narrowing. 4. Rest of the Vertebral bodies are normal in height and signal intensity. 5. Posterior arch elements shows normal signal intensity. 6. Conus appear normal. 7. Facet joints shows normal signal intensity.IMPRESSION: MRI FINDINGS S/O > DISC BULGE AT L4-L5 LEVEL CAUSING COMPRESSION OVER THECAL SAC AND BILATERAL NEURAL FORAMINA NARROWING. > EARLY DISC PROLAPSE WITH ANNULAR TEAR AT L5-S1 LEVEL CAUSING COMPRESSION OVER THECAL SAC AND BILATRAL NEURAL FORAMINA NARROWING. Please give me suggestions for early recovery from back pain which passes through my right leg. Pls give me suggestions without any surgery.[/INST]HelloThanks for your query. After going through your query I came to know that you are probably suffering from lumbar disc prolapse. It is already confirmed by MRI scan. There are two treatment options. First option is rest in position of relief(generally lateral position with both hip and knee bend), neurotopics such as mecobalamin and analgesics (Diclofenac three times a day after meals is effective). Sometimes strong analgesic(such as tramadol three times a day after meals) is required. Omeprazole before meals prevent acidity caused by analgesics. Second option is go for surgical operation(Discectomy). You can discuss with your treating Doctor about it. Hope your query get answered. If you have any further questions then don't hesitate to writing to us. I will be happy to help you. You can also write to me directly on below link:https://www.bit.ly/ask Chat Doctor. Take care.</s>

<s>[INST]My son was in a motor cycle accident and had badly broken his arm.....he has red seeping scar tissue left on the outside of were the stitches were...they have healed but this scar tissue just wont heal....they have used silver on it and wrapped it lightly.....It has been 7 weeks from his surgery[/INST]Welcome to Chat Doctor I have gone through your query and understand your concern. Your son has got bad injury and scar. You are likely to get benefited by antibiotics and analgesic such as ibuprofen for pain relief. Even if your scar is not healed then it may require investigation such as x-ray to see any cause of this. You can discuss with your doctor about it. Hope your query get answered. If you have any clarification then don't hesitate to write to us. I will be happy to help you. Wishing you a good health. Take care.</s>

<s>[INST]I was just wondering, I have been on Loestrin 24 FE for about two almost three years now, unfortunately the other day I developed a UTI and was put on antibiotics. I know it effects my pills, but to what extent and if anything arises would it be problematic to attempt intercourse?[/INST]Thanks for your query at Chat Doctor! I am Infectious Disease Specialist! I went through your query! Loestrin 24 Fe you are taking for contraception to prevent pregnancy. It must be stopped if major kidney problems. Yes antibiotics do effect the efficacy of your pills to pose a threat of pregnancy. You may use back up birth control like condoms to protect your partner from infection as well as to avoid pregnancy till you are on antibiotics. Happy to take more queries! You can also write a review for me. If you would like some more information, I will be happy to provide. You can take a follow-up query. Take care!</s>

<s>[INST]I slid off a tailgate of a pickup about a week and a half ago, it hurt and waited a few days for it to turn black and blue or yellow, it never did. Now I was rubbing my leg today and went over that spot which is to the inner side of my knee , and it was sensative to the pressure of rubbing it and it still has a lump about the size of a marble. Should I be concerned of a blood clot? I am leaving on a bus trip the next 2 days and will be sitting for 10 hours on bus. Should I rub the area and hopefully break down the lump or could I send a blood clot through my system by doing this?[/INST]Hi, Thank you for posting your query. The swelling most likely is a hematoma, which has not yet completely resolved. The skin color changes may not be so obvious always. I would request you to upload a photograph of the swelling to help us reach a better diagnosis. Also, it is safe to take a 10-hour bus journey and there is no risk of dislodging the clot. This clot is not in the veins but in the soft tissue. Clot in the vein can get dislodged, and cause problems. I hope it helps. Please get back if you require any additional information. Best wishes, Chat Doctor. Ly/</s>

<s>[INST]i Have had these bumps pop up on my penis shaft. I have had them for about a month they come and go but never disappear completely they are in sections on in a line on the top of my penis and another section on the side kinda clustered together. They dont hurt really but 2 weeks ago i had stomach pains and diarrhea and now i have a really bad cold and head aches. The bumps are very small and raised. I either think its herpes or moncallousim contagious (dont know the correct Spelling) can some one please help[/INST]HelloThanks for query. Based on your statement I would say that you have multiple small Sebaceous Cysts over shaft of the penis. The penile skin is rich in sebaceous glands and hence prone to get more sebaceous cyst due to accumulation of sebum beneath the skin. Normally they fade away without treatment however they need to be treated if increase in size or get infected. Please consult qualified General Surgeon for clinical evaluation and further treatment. If needed some of them which are bigger may need to get excised in Toto (Completely along with the sac) Chat Doctor. </s>

<s>[INST]HelloMy age is 29 Im trying to conceive but my periods r irregular I have pcos history but now it is OK my USG ,hsg test r OK follicular monitoring done for two cycle in first cycle 18 day ovulation without medicine. In next cycly 14 day ovulation with medicine.I am suffering for mild side back pain over a month and feeling muscele stretch kindly suggest me for the next so that I got positive result[/INST]Hi, Thanks for the query. As you are ovulating regularly and as all tests are normal, once check for semen analysis of your husband to rule out the male factor. Sometimes ovulation induction can lead to hyper-stimulation. You have to rule out that and pelvic inflammatory disease as possible causes for your pain. If all are normal, you plan unprotected intercourse around the time of ovulation. This time possibly you will get positive result. For more details you can ask me through: http://www.ChatDoctor .com/doctors/ Chat Doctor. </s>

<s>[INST]I have been back to dentist since she fiilled a rear molar as i have a rotten taste in my mouth and when i press the gum i get a bad smell on my finger tip. I was told that it was nothing so Brush the area well at least twice a day. I have recently been suffering heart palpitations and wondered if there was a possible link? I intend returning to my dentist to insist on a more thorough check up as it is not normal to have such a bad smell or taste in my mouth only a few hours after brushing.[/INST]Dear friend. Thanks for sharing your concern. Poor oral hygiene can affect not only your mouth but also your heart by transporting the bacteria through the blood route.Therefore, you should be cautious in this regard. Regarding your dental treatment, please see your dentist and get through cleaning of your teeth and gums done.Meanwhile, use antiseptic mouth washes, also maintain very good oral hygiene. Hope it helps. Thanks. Take care.</s>

<s>[INST]Hi,I have been taking keppra for one and a half years now. I started with 1 gm in the morning and 1 gm in the night. My doc has gradually reduced the dosage to 500gm in the night now. However I have grown highly photosensitive. I see colour balls in bright light and I can t find a possible explanation.[/INST]Hi, I had gone through your question and understand your concerns. They are side effect of Kendra. It is a photosensitivity reaction that occurs in a few people that take Kendra, often associated with other ongoing diseases like hypertension, depression, rheumatoid arthritis, high cholesterol. Hope this answers your question. If you have additional questions or follow-up questions then please do not hesitate in writing to us. I will be happy to answer your questions.</s>

<s>[INST]My father is 85 and he keeps getting periods of stomach pain and aching all over his body, feeling very cold and not being able to get warm. He cannot settle and goes off his food. Usually lasts over 24 hours. These episodes start out of the blue and are becoming more frequent. Any idea what this could as he lives on his own and becomes anxious.[/INST]HAI, at this age there can be many problems usually age related such as azaleas, Parkinson, degenerate disorders, or other age related problems. This sort of sudden episodic disorders can be in case of parkinsonism, rigidity, cold and clammy episodes, associated hysterical episodes, at the age of 85 better he should have a caretaker. U cargo ahead for a ct brain, abdomen ct or ultrasound, sugar levels, serum electrolytes, urine routine.pls take him to general physician and a neurophysician, Food luck</s>

<s>[INST]I am a wind musician. The center of my upper and loer lips is numb after playing a show that I was biting too hard on my sax and clarinet mouthpieces. Its been several days and still numb. How can I speed up recovery? It s killing my flute playing...[/INST]Hello, I feel there might be a lot of muscle weakness and need to be checked out once. Sometimes due to weakness, there might be pressure on the facial nerve and that can lead to some symptoms like what you are facing. I prefer you do some facial exercises and if the symptoms of numbness don't subside then you can get it checked in person with a physician as muscle can be examined by personal visit. Hope you understand that as humans we have certain limitations to come for a close diagnosis. Hope I have answered your query. Let me know if I can assist you further. Jay In Chat Doctor. </s>

<s>[INST]I have lower belly pain and very tender to touch pain is between rectum and vagina bladder doesnt feel bad.when i pass gas its very sore as it passes by the painful area.its in the area of the douglas pouch i think (i have no uterus)I had a catscan with contrast a week or so ago and then my kidneys were very flared for about 5 days (i have lupus sle) is this cause for concern? What would treatment be.Ive never had such discomfort and tender to touch like this.this is the 3rd day of this and only worsening[/INST]Maybe per anal abscess fissure and fistula. Sis-bath is to be done. Apply appointments per rectum. Get locally examined by surgeon maintain hygiene and sanitation. Per rectal examination is to be done if required cryosurgery can be recommended ultrasound pub can be done. Nephrologist can be consulted for examination and advise on treatment. May be related to lupus. Second opinion can be taken for treatment.</s>

<s>[INST]Hi, may I answer your health queries right now ? Please type your query here...My granddaughter is 12 and started her period this summer and is on vyvance. Recently she has become more impulsive, sassing and just not being herself should her meds be changed?I can t afford to pay[/INST]Hello, With the beginning of the adolescent age, personality changes also begin. A child may behave in a totally opposite way as he or she has been. Just wait and watch, and be patient with her. Try to understand her turmoil bad mood swings. There does not seem any need for medication for monarch. Reconsider any medication if she has regular menses. Hope I have answered your query. Let me know if I can assist you further.</s>

<s>[INST]dear doctor ,My orthopedic surgeon says both my knees are worn out and the findings are that reduced joint spaces with osteophytes noted, suggestive of moderate osteo arthritis and he has advised for replacement . how safe are these surgeries because i am a diabetic patient, suffered asthma attacks earlier, Should I continue with medication or should i go in for surgery. please advise.Philomena[/INST]Hello, Thank you for your question. I think if your Diabetes is under control and level of sugar in blood is normal then surgery is safer. Of course after the surgery because of the stress the Diabetes may disbalance, so you should be careful to check often especially in the first weeks after the surgery for the wound to heal without infection. The same is with asthma. If it is under control with medication it is not a reason to stop the surgery. Best regards</s>

<s>[INST]I am a 55 yr old reasonably fit male. I weight 87kgs at 173 cms tall. Overnight I have developed a lower abdomen pain - below the stomach button. I have now had it 16-17 hours. It is deeply seated. I havent had the much to eat since I am doing the 5/2 diet to reduce my weight to a goal of 83kgs as I am an active rugby referee in New Zealand. I ate the same as my family last evening (i.e. a small piece of fried pork, 120 gms boiled potatoes and 100 gms mixed green vegetables). I have been able pass urine after drinking 1 cup of tea and 2 cups of coffee and probably 2 litres of water. I thought it was a bowel problem but I was able to go about 12-14 hrs ago. I have suffered from lots of gas over the last few years and that can be really uncomfortable and again I thought that was the problem but it is a sharper pain. I had a small dinner 3 hours ago and the pain was immediately worse. I have been having raspberries, blueberries and cherries over the last week and wonder if a cherry stone could a blockage or could there be another issue/[/INST]Hi. This ca not be due to berries as there would have been distension, vomiting, constipation if here had been an obstruction. This may be an intestinal infection because your pain is almost constant. A course of an antibiotic, metronidazole and probiotic should be of help. It is better to get checked by a Doctor as you need a clinical treatment and a prescription too. On a safe side go for an ultrasonography to rule out any other organic lesion/.</s>

<s>[INST]I have terrible pains in my back, have discharge brown and smelly, have had 3 lots of antibiotic so far for suspected uti, pain in lower groin and shaky sometimes, I dont think i have uti as no other symptoms apart from urgency to urinate frequently.[/INST]HI, thanks for using Chat Doctor Back pain and persistent vaginal discharge may be related to infection of the genital tract, possibly pelvic inflammatory disease (PID). This can be confirmed by physical examination, review of your symptoms and in some cases investigations. There are particular courses of antibiotics that are used for this infection and the course is prolonged. You may want to consider visiting your gynecologist for review. I hope this helps</s>

<s>[INST]Hi there, thank you in advance for your answer. This question regards menstrual bleeding and possibly pregnancy. My husband and I have been trying to conceive for several months now. My menstrual cycle is every 31 days on the spot. It is always very dark, very thick, and very heavy with medium sized cloths. This month my period came a day early, for the entire day it was pink spotting only. The following morning it came on as a very watery light red, as the day went by it stopped and started again a few times, again very light but not near light enough to be called spotting. By day 3 it was completely gone. Usually my menses lasts between 5 to 7 days. Again the bleeding was very watery. Is there still a change for pregnancy? Either or, should we be concerned?[/INST]Cellophane you for your query. Any kind of altered menstrual bleeding always raises the chance of pregnancy. I would advise you to go for a home pregnancy test after 3 - 4 days if your period doesn't show up by then properly. Other causes of such altered menstrual bleeding could be :Stress, anxiety, emotional upheavals, frequent travelling, intake of hormonal medications, thyroid disorders, polycystic ovaries etc. Such scant spotting once in a while is a normal occurrence also. To reassure yourself completely, you can visit a gynecologist for detailed evaluation and tests. Take care</s>

<s>[INST]II have been running fevers for over 2 months after a bout of pneumonia, I just had a central line removed after ten days of home antibiotcs and the line became infected,positive blood cultures for gram negative rods. I still have a productive cough and temp. along with positive cultures obviously antibiotics did not help, my concern is I am an organ donor and I do not want my heart damaged as my brother died from a similar issue after needing a heart transplant due to a similar issue.What should be my next step?[/INST]Hello dear, thanks for your question on Chat Doctor. I can understand your situation and problem. I advise you to consult pulmonologist and get done 1. CT THORAX2. Bronchoscopy and BAD analysis. We need to identify the causative organism and sensitive Chat Doctor. CT gives excellent imaging of lung parenchymal and thus improvement or worsening of previous pneumonia bout can be diagnosed. BAD is very sensitive for identification of organism. So antibiotics can be guided. So consult pulmonologist and discuss all these.</s>

<s>[INST]Hi , I m akshay . . Actualy I m suffring from hepatatis B and I dnt know from where I got the virus of It . Also I am addicted of mastubration . I dnt knw how I becme addicted of It and now I am at the stage of mastubration when I did thrice a day due to which I m suffring from these undergiven problems Problems are : 1. A liquid comes over ma penis before mastubrate 2. My penis become shrink , 3. Early realeses of sperms ,4. Sperms became very fluidic and thin like white water 5. Pain in ma leg joints, headache , eyesight effected alot. I think I am almost ended ma self through this bad habbit . . I m 18 years old . One thing more does mastubrate during hepatatis B effects my body ?? I tried to leave this but I cnt . . I want to die . . So can u plz help me out ?? Plz gv me right direction My contact no. Is +0000 help me if u can . . :-([/INST]HelloThanks for query. Based on the facts that you have posted its ems that to have been indulged in frequent and habitual masturbation since many years and now facing problems related to general health and sexual health. At the outset I would like to state that there is a myth and general opinion and misconception in mind of a common man that frequent and habitual masturbation leads to problem like premature ejaculation and weakness joint pain loss of weight etc.However, I have been proved scientifically and discussed on various scientific forums a;; over the world that masturbation has no ill effect on any organ or system in the body. All the problems that YOY are facing all due to anxiety. Following general measures will help you to improve your general health and resolve sexual problems like premature ejaculation .thin watery semen etc. 1) Practice regular exercise for 45 minutes followed by meditation for 30 minutes every day morning .2) Take high protein diet rich in fruits, vegetables .3) Take anti oxidants like 5=7 almond every day 4) Avoid smoking and alcohol 5) Get yourself involved in social activities, reading, listening to music, sports etc. so that you will not get free time to masturbate. Please remember nothing is lost .you have still long time to achieve in life. This will get resolved over a period of year or two, and you will have normal.peaceful life. Chat Doctor. </s>

<s>[INST]Hello there please can you help my baby son of 20 months old had been up all night with what seems to be a high temperature I have taken it under his arm and on three times I got a reading of 39.2 he seems out of sorts and wont sleep. I have opened the bedroom window and reduced his clothing to his vest and nappy. I have given his 5mls of medised I am worried about him is there anything else I can do to help him. Any information or advice would be very much so appreciated Yours Sincerely Mrs Gemma Hamilton Contact 0000[/INST]Hi dear, If there is no other symptoms associated, a sudden onset fever is probably a viral fever, and need not be worried. Just give him paracetamol 3-4 times a day for 3 days. If fever is not coming down after 1 hour of paracetamol, you can give syrup metonymic acid(100 mg/5ml) 4ml, maximum 3 times a day. If the fever is not coming down in 2-3 days, he becomes lethargic or not taking feeds, kindly take him to pediatrician for further evaluation. Hope I have answered your Quertle me know if I can assist you further Chat Doctor. </s>

<s>[INST]Hey my name is kaitlyn.. I had barin surgery when i was 6 it was because my brian was falling down to my cord.. well im fine now and i was very sick when i was little as well... Well me and my boyfriend are both 20 and we are trying to get pregnant... The thing is how much of a chance is it that my kid would have the same or more of a chance to get sick twith the same thing i had?[/INST]Tithe point is that some conditions are hereditary and other diseases are acquired. What you have told us in the query is the end result and the common complication of many conditions including post lumbar puncture. There is a possibility that you had what is called HY Chat Doctor. So you were operated. Now if you have some condition that is genetic, the offspring may have the condition. If it was acquired, like say post meningitis, it is acquired and cannot be transmitted Best of luck</s>

<s>[INST]I have had what looks like leukoplakia on my tongue for more than a month. I visited my doctor. He diagnosed it as bacterial and gave me a course of antibiotics. But it hasn t cleared up. I took it despite being 2 months pregnant. But I am getting worried now because its still there, I have a heavy feeling on my chest and I am starting to experience hoarseness. Please advise. I am worried![/INST]Hello, Thanks for consulting ChatDoctorRead your query, as you have white patch like lesion on tongue it is not necessary that is leukoplakia it can be bacterial or fungal infection, lichen plans or functional keratitis. Don't be worried so much as you are pregnant also don't take stress I will suggest you to consult good oral surgeon for examination of tongue and give your history of pregnancy to dentist and if he prescribed any antibiotic then discuss with him dosage and take it in proper prescribed dose don't take overdose of any medication. Now as you are taken antibiotic, and you are feeling uncomfortable in chest now you should consult your general immediately for examination of chest. Hope this will help you.</s>

<s>[INST]I WOULD LIKE TO KNOW ABOUT BIPOLAR THAT IS UN TREATED WITH MEDS AND HE ALSO HAS PTSD NON MILITARY AND WHAT ARE THE SIDE EFFECTS OR HOW DOES VICODIN EFFECT HIM HE HIS TAKING THIS FOR A KNEE INJURY THAT IS RATHER PAINFUL HE IS IN ALOT OF PAIN I HAVE NOTICED SOME CHANGES IN HIS MOOD WITH ME LATELY IS THIS DUE TO THE PAIN ??[/INST]Hi, As you describe your dear one is suffering from Knee pain, Bipolar disorder and PTSD. The Vicodin contains codeine which is an opioid. Opioids are known to precipitate mania. The stressors due to pain, due to medicine and due to PTSD all may additively fuel up an affective episode. May it be depression or mania. You have not mentioned the eat reason for not taking medicines for Bipolar disorder. My suggestion is to start him on a prophylactic dose of mood stabilizer like Sodium valproate or carbamazepine. These may also have added effect on controlling pain apart from preventing a relapse of mood symptoms. Visit a psychiatrist before starting medicines as the dose needs to be set depending on the dose of Vicodin.</s>

<s>[INST]I just gave my 2 year old a bed time snack consisting of banana and avocado, within minutes she had a couple of itchy spots on her cheek. I also noticed her taking deep breaths and pulling her ears. I gave her the same snack last night, the same thing happened. I find this weird because she always eats these foods and they have never bothered her before. Any uggestions?[/INST]Hi there, Thanks for writing in. It is possible to develop an allergy to a substance even though there have been no allergic reactions to the same previously. It is important to avoid avocado, as the reaction can become more severe with future exposures, and your baby could be at risk of serious allergic complications. Please do avoid avocado and banana in the meantime. Do consult your children doctor for thorough examination and assessment. Hope this helps.</s>

<s>[INST]Sir, My 14 years old son is suffering from HSP. Now his urine protein is + with 6-10 RBC and 2-4 pus cell. some time he feals knee pain. He is taking maxipa & enam-5. It is running for 6 months. Rutin urin test report shows some time normal and some time protein+ or ++. Now his Protein/creatanine ratio is .142What I have to do for betterment.RegardsBiswajit BhowmickKolkata (W.B) 98311 23793[/INST]hi HSP is Enoch scholar purpura. In this disease there is inflammation in kidney and skin leading to loss of protein and red blood cells in urine. This is a self limiting disease in most patients within 3-4months. In case of your son since the disease is already running for 6 months, in my opinion we should review the diagnosis. If I was your sons treating doctor I will consider doing ANA,C3 and C4 blood tests and also will consider kidney biopsy for definitive diagnosis. I will advise you to see a nephrologist and discuss these issues hope my opinion will benefit your son. I wish him good health!!!thanks Chat Doctor. </s>

<s>[INST]I am a 59 year old male. I had a prostatectomy last year due to prostate cancer. I am currently suffering the following: severe lack of appetite, nausea, confusion, severe pain in lower abdomen (both sides), severe weakness, sweating, sometimes fever, pain between shoulder blades (not constitent). I am also a diabetic and sugar has been running just over 300 for the past three weeks. Please advise.[/INST]Hello, All these symptoms is due to Hyperglycemia(increased blood sugar). Once the blood sugar is controlled the symptoms will gradually subside. I would advise you the following Consult your doctor and take his help to control the blood sugar by adding insulin. Check your HbA1c level and maintain it between 6 and 7 %. Diet and exercise should be followed strictly. Secondly screen for any recurrence of Prostatic cancer.</s>

<s>[INST]ChestIve been feeling a lot of pressure and heaviness on my lower chest for two weeks now . Along with random sharp pains that get worse when I breathe in . Its difficult to breath and its really uncomfortable . My heart is also pounding and I keep feeling like there is air stuck in my chest and I try burping . My chest also burns at random . I cant do any acivities anymore because I run out of breath fast and its difficult to sleep also . I want to know what I may have Age : 16 Height : 53Weight 96[/INST]Thanks for your question on Chat Doctor. I can understand your concern. By your history and description, possibility of gastroesophageal reflux (HERD) is more due to your weight. Obesity is known risk factor for HERD. It is due to laxity of gastroesophageal sphincter. Because of this the acid of the stomach tends to come up in the esophagus and cause the symptoms of burping, gaseous feeling in stomach, chest tightness, heaviness, burning central chest pain etc. So better to follow these lifestyle modifications for symptomatic relief in HERD. 1. Avoid stress and tension. 2. Avoid hot and spicy food. 3. Avoid large meals, instead take frequent small meals. 4. Start proton pump inhibitors and prokinetic Chat Doctor. 5. Go for walk after meals. Keep 2-3 pillows under head in the bed to prevent reflux. 6. Do regular aerobic exercise and lose your weight. 7. Avoid smoking and alcohol if you have these habits. Don't worry, you will be alright with above-mentioned modifications. Hope I have solved your query. Wish you good health. Thanks.</s>

<s>[INST]Last night, I had horrible lower back pain that radiated all the way down my right leg into my foot. Today, the back pain isnt as bad. However, Im having period like symptoms; lower abdominal cramps, nausea, lower back ache, light headedness/headache, and even the period smell when I use the bathroom. Is this normal?[/INST]Hi. Thanks for query. Noted your history of sudden horrible pain in the back that got radiated to the right lower leg to foot. This is suggestive of sciatica. This would have been enhanced by the congestion caused in the pelvis by the menstruation which you got the second day or will get soon as you have symptoms like that. This is normal meaning these things can occur simultaneously. I would advise you the MRI of the lower spine to see the cause of sciatica, its extent and to decide the future course of action for the cure. This may be done by medicines and physiotherapy, weight reduction and so on. If the conservative measures fail, you can go for surgery. Consult a Gynecologist if there is any gone problems.</s>

<s>[INST]I did a mamograph and it came clear but did an ultrasound and my doctor tells me that they found a lump lymfod under my armpit and have asked to do another ultrasound in two months? my question is, does this mean I have cancer and at what stage? pls advise[/INST]Lump in the arm pit could be due to many causes mostly infection or benign lesions. However, it is important to rule out secondary enlargement of lymph nodes from breast cancer. If you are in the high risk group like family history of breast cancer/ obese/ multiparous then It's important to rule out carcinoma breast. Since your mammogram is clear not to bother, repeat a scan according to your doctors advise, or get a cytological examination done and if you notice a lump in the breast, hard and fixed, do consult your doctor immediately. Hope this helpsRegards</s>