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<s>[INST]hi i have multiple lumps symmetrically on my body, neck front and back, on my trunk,back of knees elbows, front of ankles ect, im getting a lot of pins and needles too? query dercums disease but i think its more to do with my lympatic system can you advise please[/INST]Hi, Dear,On the data given, I would need more information as follows-How long they are there? How long with pins and needles? What about the size of these lumps? Any burning and itching in these lumps. You seem to have -Multiple neurofibromatosis ? Or multiple lipomatous ?or may be Urticaria with lumps. To resolve this issues I would advise you to consult ER Surgeon. Hope this would resolve your query. Welcome for any further query in this regard. Write good review and hit thanks, if this reply helps you. Have a good day. Chat Doctor. N.</s>

<s>[INST]Hello, I do a fair amount of cycling, and Ive had a hard bump on my inner thigh for a while. It is painful while riding and sometimes is painful and has a chafing feel during inactive moments. I assumed it was an ingrown hair and would go away, but it has not and has recently grown a little bit in size. Today, as I was taking a shower, I pinched the sore spot and a large amount of blood came out. There have been small amounts of blood coming out throughout the day after the initial rupture[/INST]Hi. Thanks for your query and an elucidated history. This looks to be ingrown hair - boil as you have rightly suspected. You have ruptured it during the stage of cellulitis that is inflammatory stage only; so the bleeding throughout the time you mentioned. It would be wise to start an antibiotic and anti-inflammatory medicines under the guidance and prescription of a Doctor. Also get a sterile Chat Doctor. This may settle well.</s>

<s>[INST]Yesterday I was bitten by a small black ant outside on my pinky knuckle and now its really swollen and I was just wondering why because Ive been bitten by ants plenty of times and its never gotten swollen so yeah I was just wondering why that was. Thank you!![/INST]Hello, Welcome to Chat Doctor, A number of treatments are available for ant bites, although they can resolve on their own without any intervention. Immediately after an ant bite, the bite should be washed with warm water and soap. This will reduce the risk of developing an infection as a result of the bite. Taking an antihistamine like Ben Chat Doctor. Cortisone cream can be applied if the bite becomes very itchy. Thank you.</s>

<s>[INST]For the last hour, I noticed my tongue feeling wierd on the left side. Haven t bitten it or anything. So, it was bugging me so I looked in the mirror and it has like a reddish bruise -- but it doesn t hurt. Appears to only affect the top side of my tongue.[/INST]With such presentations in my clinic - I come up with these possibilities:Soreness of tongue (Glossies) is often caused by nutritional deficiencies and may be painless or cause discomfort. Glossies usually responds well to treatment if the cause is identified and corrected with multivitamin tablets or vitamin B complex tablets. For reducing the pain you could use glycerin. Iron-deficiency anemia is another cause of soreness and is mainly caused by blood loss, such as may occur during menses or gastrointestinal hemorrhage. Multivitamin tablets can help. Bacterial, viral or fungal infections can cause glossies so if any infection with layer of white patch is found on the tongue that means the tongue is infected and should be treated with antibiotics. If it was oral candidiasis(white patch) common in asthma patients - Statin : swish and swallow should be done. 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 brother started a publishing house, and had lots of hopes for its success. Unfortunately he failed in his business. He is highly qualified and writes very good and sensible blogs. The problem is he keeps thinking that one of us, the family members have done something to contribute to his failure. He blames all of us for his failure, so much so that he has gone away leaving his family, even his wife and kids. his old mother as well as sister. He writes blogs and occasionally publishes a book. He is isolated, has no contact with us. I wonder if he has a psychological problem. Please help me understand my brother s behavior.[/INST]Hello, The information of your brother is reflective of delusional disorder. In his case he has suspicion over his family for ruining his business. Such illness initially affects family life and relations of the patient, and it is not possible to convince them for treatment. Usually, lately the health, self-care and work is also affected. There can be add-on depression or anxiety above the delusional disorder. The only way to treat such patient is by giving them medicines regularly. They should be brought back to family home and meds are given hidden in food or forcefully or by regular convincing them. With Chat Doctor. Within few days there is good improvement in most of the cases but </s>

<s>[INST]my husband woke up with small red bumps on his face, head, armpits, around the nipples, palms and soles of his feet . There are about 12 in his armpits and the are extremely sensitive, hot but not itchy at all. His hands are very sore and hard to make a fist. He cannot grip anything without alot of pain. His only other symptoms are extreme fatigue . My Son had the same exact thing happen about two weeks ago....exact same symptoms and bumps. I took him to the E.R. but they had no idea and said it could be an allergic reaction but the nurse thought it could be viral. Please help me find out what this could possibly be. Thank you for your help, Tami[/INST]IT SEEMS TO BE VIRAL IF YOU GET BLOOD TESTS DONE YOUR IF YOUR PLATELETS ARE NONWHITE BLOOD CELL COUNT IS LOW IT MEANS IT IS Virtue PLATELET POINT CAN ONLY BE INCREASED BY STRICT BED REST AND PLENTY OF FLUIDS IN ANY FORM AT LEAST 4 TIMES IN ONE HOUR WHEN YOUR FATIGUE IS GONE IT MEANS YOU HAVE RECOVERED THE PLATELET COUNTRY CAN TAKE DICLOFENAC AS PAIN KILLER AND ADD SAFE ANTI-ALLERGIC TAB LORATADINE 10 MG APPLY CALAMINE LATIN AND MOMETASONE OINTMENT ON THE SKINT MAY TAKE 2 WEEK TIME TO RECOVER</s>

<s>[INST]Over the last 4 days, the gum above my right front tooth became sore, was red but not swollen, formed a kind of head (no pus), and today has a small brown scab. Still a little sore, but very localized and not swollen. Any ideas about what this could be and whether it requires immediate attention?[/INST]Hello, Welcome Thanks for consulting Chat Doctor, I have gone through your query, as you have gum sore this can be due to periodontal problem. You can apply gum paint on sore gum two - three times a day for one week. Do Luke warm saline gargle two - three times a consult dentist for investigations IOWA x-ray and go for scaling and curettage if periodontal problem and if due to periapical pathology then go for Root canal treatment if needed. Hope this will help you.</s>

<s>[INST]i am a 13 year old girl and my mom had breast cancer and now i think i have it. because i have plenty of the side effetcs like the lump and stuff. i have had it for 3 months about. i wanna know does breast cancer make u feel sick. also does it ake ur attitude cange becausse i have been on edge alot latley and i am really scared.[/INST]Hi, dairy have gone through your question. I can understand your concern. At age of 13 breast cancer is very unlikely and chances are almost negligible. You may have fibroadenoma or fibroadenomas. Your mood swings are due to hormonal changes. It is not due to breast cancer. Consult your doctor and go for examination. If needed go for fine needle aspiration cytology or biopsy of breast lump and take treatment accordingly. It is not breast cancer so don't worry about that. Just be relaxed. 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]hi doctor iam 70 years old 50 kg and 6 feet height last 3 years back TB treatment taken 9 months and it is clear, after 3 years head achec and fever started around 3 months,now continuous caugh, again TB came now i want to continue treatment is it cure, pls advise me.[/INST]Cellophane you for making in Chat Doctor. First this last time I think that the lung specialist have done the diagnosis of recurrent TB, i hope. It is very important to be sure that it is a TB again, and what is the reason that tb is come back? If the treatment was the right one, and you have taken it regular till, or maybe you might have any other diseases not known yet or may we are in a case of M Chat Doctor. You have to go to the specialist again. Thank you</s>

<s>[INST]Hello I am a 23 year old white male 165 lbs and I had something happen that scares me. I had drank that night some vodka and thats about it; but later that night I ejaculated blood! Part blood but enough to get the picture. So...im nervous and need professional advice. This has happened once before but it was more pink than red. I figured I busted a blood but I need your advice. Thanks[/INST]Hi thanks for contacting Chat Doctor .... First infection of accessory genital organs like seminal vesicles, prostate, epididymis might be infected that can lead blood in ejaculation.... For that ejaculated Semen send to lab for analysis .... If shows pus cells then antibiotic given.... If fever, weight loss like feature present semen tested for tuberculosis ..... If needed culture can be done....USG abdomen will also be helpful.... Trans rectal palpation and ultrasound will be helpful for rule out prostate cause.Meanwhile, healthy and balanced diet taken... Fruits more. Keep alcohol and smoking very restricted. Consult surgeon with keeping my answer in mind. Take care</s>

<s>[INST]Hello Doctor, This is regarding my mother s health. She is of 65 years old. She doesn t have any B.P. , diabetics as per her every 3 months checkup . But she is very badly suffering with pricking sensation, burning and pinching in her both feet . She is suffering it from the last 4 years . But sometimes the pain is unbearable throughout the day . She cannot stand or walk for more time. Otherthan this she has no other complaints. Please please kindly tell me the reason for this pain and also the proper specialist for this problem . They stay in a town. She could show to a specialist in Vizag in Andhra Pradesh in India. Please kindly tell me your advise . We are very greatful to you.[/INST]Dear enquirer Thanks for your query The pattern of symptoms your mother has suggested either peripheral neuropathy that is affection of the nerves of the legs or remote possibility of spinal cord problem. The investigations which mainly would help are1. Nerve conduction studies of the upper and lower limbs2. Vitamin B 12 and vitamin D levels3. If indicated Protein electrophoresis4. Urine BJ Proteins5. ESR, RA Factor and CRP Before all these she needs proper assessment by a neurologist. Thus, I Suggest book an appointment with neurologist at VIZ AG at earliest. Depending upon this test treatment for general symptomatic relief as well as for treatment of underlying condition can be planned.</s>

<s>[INST]my two kids one girl-3.5yr old,13kg and anther boy-2yr od,10kg- are frequntly suffering from cough and cold fever .they are taking antibiotics in evry month for their dieases.regularly taking antiallergy(nukast 4mg or montair 4)in every 6 months for a longer duration.we are living in adusty industrial area.i tried every alternatives but faied.what to do?[/INST]Hello, Both of them are definitely suffering from persistent rhinitis/rhinosinusitis that is a risk factor for development of asthma. Montelukast is a good choice for the lung and for exercise induced asthma but allergy testing is required to ensure you are aware of exactly the allergens your kids are sensitized to, example house dust mite or animal dander or molds. Precaution works a long way in preventing exacerbating allergies and long acting non sedating antihistamines plus nasal corticosteroids prevent ongoing nasal inflammation and subsequent asthma. Thanks.</s>

<s>[INST]i fell on the ground & for a second couldnt breathe but after that i was fine the next day i started feeling pain where my ribs are i only really feel it when i take a deep breathe yawn or sneeze is this a bruise fracture or break & will this be able to heal on its own & how long will it take[/INST]Hello, As with the history to clear the confusion out whether it is a bruise or a fracture of the rib, a simple chest x-ray will be good enough. If it was a big fracture there might be much more changes. Any direct injury to the rib cage can lead to pain and difficulty in breathing, sneezing and coughing. Most rib fractures, if they are hairline, heals on its own, but x-ray will be a good choice still to take it for safer side. Also, whenever you are sneezing, yawning, or doing deep breathing, I will advise you to put the hand over the painful area so the pain doesn't increase. In my clinical practice of over 12 years, most rib fracture cases or pain in ribs due to falling recover well with conservative therapy and preventive measures. Hope I have answered your query. Let me know if I can assist you further. Jay In Chat Doctor. </s>

<s>[INST]I am having uncontrollable urges with my tongue. I am pushing my tongue against my teeth. As well as rubbing and pushing on my gums where they meet the teeth. I see that I have already started shifting my teeth and caused gaps. The pain of my teeth and gums are horrible but I can not control it most days. I also see my gums receding, lifting, bleeding and tearing. Also I am starting to notice cracks in my teeth. My top 2 front teeth to be specific. This is the target area of my urges to push and rub on my teeth and gums. It used to be the bottom but now my tongue cant seem to relax and rests mainly on the roof of my mouth. What could cause something like this?!![/INST]Hi. Thanks for the query. As per your complaint the symptoms that you are explaining is pointing towards TONGUE THRUSTING HABIT. In this condition the individual tends to push his tongue against the front causing spacing between the teeth, pain in teeth and gums, misaligned teeth and gum diseases. It can occur due to a number of causes like Sinus and adenoids related infections, large sized tongue or Macroglossia while stress can also be an important contributing factor. I would suggest you to consult an Orthodontist and get evaluated, and he can fabricate an orthodontic appliance known as Tongue Crib that will prevent hitting of tongue over the inner aspect of teeth, and you will test your tongue on the crib that will gradually reduce the habit. If you have stress then deep breathing exercises, meditation and if needed a consultation with psychologist can be made who can do counseling and advise you antianxiety medication. Hope this helps. Regards.</s>

<s>[INST]I went to the doctor today for wrist pain in my right wrist. It has sharp shooting pain that goes up into my shoulder. I do not have any tingling or numbness associated with carpal tunnel. An x ray showed a difference between my ulnar and radius bones and there is an indentation when I bend my wrist down. Is this carpal tunnel or could it be something else?[/INST]Hello, I have studied your case, and It is very difficult to tell about this pain. I think it is most probably due to cervical spondylitis or nerve compression in the limb. I would suggest you to get EMG?NCV examination of the upper limb to confirm this diagnosis. If there is any nerve compression then you need to get small surgery to get it removed. I would also suggest you to take Pregabalin and Methylcobalamine. I hope these steps will be helpful for you. Let me know if there is any other followup questions. Thanks</s>

<s>[INST]Diagnosed last week with asthmatic/bronchitis and sinus infection. Prednisone pack completed as of yesterday morning. Azithromycin finished past Sunday. X-ray showed no pneumonia. Now my neck, upper arms, and entire back are sore. Sort of like a t-shirt area of soreness? Influenza???[/INST]Thanks for your question on Chat Doctor. I can understand your concern. Yes, viral infection with Influenza can cause muscle weakness and soreness. Another possibility is steroid induced myositis (inflammation of muscles). Prednisone is oral steroid and can cause muscular pain and soreness. Viral infection is mostly self-limiting. And you have also finished prednisone course. So better to wait for 1-2 more week. You will mostly improve. But if your symptoms persist than consult doctor and get done clinical examination. Hope I have solved your query. Wish you good health. Thanks.</s>

<s>[INST]My others Xray report Showed: Mild Aortic Unfolding, Minimal Cardiomegaly & Mild Scoliosis. Is this very Serious. If we take the medicines will this be cured completely. Will she be able to work & do things very actively. She is 53 years old. PLS HELP me. I want to know that is she is fine...[/INST]Hello, Regarding your concern, I would explain that a chest X-ray study is not the best tool to examine the heart. For this reason, I would recommend performing a cardiac ultrasound and a resting ECG in order to examine her heart function and structure. I would be glad to review her test reports as soon as you will be able to upload them for a second opinion! Hope I have answered your query. Let me know if I can assist you further. Take care Chat Doctor. </s>

<s>[INST]Hi my father is 87 and was hospitalised last week saturday... he was diagnosed tht he has Pneumonia/ lung infection... its been more than a week now but ther is no progress in his condition.... yesterday he seemed fine but today he s weak nd thy put him on oxygen... wl he survive ?... its killing me to see him to like that. Please be honest with me Dr[/INST]Hi I do care for your concern. Pneumonia most of the time caused due to bacterial infection of lungs. It usually takes 2 to 3 weeks to completely get cured of this disease with adequate medical care. You have mentioned his age to be 87 and during this time his immunity will be somewhat lower and also his nutritional status. As the infection occupies some space in lungs, usually oxygen mask in provided. With adequate medical care and nutritional support pneumonia as such can be completely cured, unless complicated by other associated medical conditions. Hope I have answered your question, If you have more doubts feel free to ask. Thank you.</s>

<s>[INST]am lady of 21 years old i am married i have been trying to fall pregnant bt it doesnt happen i had miscarriege before so i was told to take folic acid pills and get neoubion injection in order for me to fall pregnant yes i did that but still im not pregnant but i have running tummy ,my body is itching , and i feel like vomiting in the morning bt if i check im not pregnant can you tell me what is the cause of that. Reply Forward[/INST]Hallow Dear, Missing a period is the first cardinal symptom of early pregnancy. When you have not missed your period, nausea in the morning may de due to increased acidity or stress of not becoming pregnant. Some antacid will give you relief. The very fact that you had a miscarriage once means that you were pregnant. Thus, you have proved your capacity to be pregnant once. Hence, your eggs must be forming regularly, and your husband should be having good quality semen. The only question is whether you contacted any minor infection during the miscarriage which had resulted in tubal blockage. Please get hysterosalpingography done to find the evidence of tubal patency. If the tubes are blocked, you may require surgical intervention for reopening the tubes. If the tubes are patent, please monitor egg release (ovulation) by ultrasonography from day 9 of the cycle. On and around the day of ovulation, try to have sexual relations maximum times. You can give such fair trial for at least three months. If still it fails to make you pregnant, please report to Infertility specialist for further investigations and treatment. I hope this helps you. </s>

<s>[INST]hi i ave lower back pain like a dull ache an also vagina numbness an discomfort, i am on the pill an in relationship. i am 6 days back into my new packet of pill an have seen a doctor an was precribed antiboicts but dont seem to be working am on my last day of a weeks percription plz help[/INST]Hi there. You are probably suffering from Pelvic inflammatory disease. This sort of pain can be referred to the back commonly. If your antibiotic is not working then you need to get a vaginal swab culture and sensitivity test done along with a urine culture and sensitivity test. Start antibiotics according to the culture report. For back pain take an analgesic and muscle relaxant for the time being. I hope my advice has helped. Good luck</s>

<s>[INST]Hi, may I answer your health queries right now ? Please type your query here...I had a difficult tooth extraction on Monday, the dentist put me on amoxicillen and I was sick and nauseous and dizzy the day after; could not get out of bed. He changed my prescription to amox-clan; but it still has not helped; I have headache and overall sick feeling.[/INST]Hello, Please contact your dentist to update your symptoms. Make sure you have ruled out any allergic reaction or intolerance to Amoxicillin. You may need to change the antibiotic again. You need to control the spread of infection into your blood stream that can give you systemic affects. Follow all instructions provided by your dentist. Try to take a combination of two Advil and two extra strength Tylenol at regular intervals (as long as you are not allergic and can take these anti-inflammatory pain relief medications). Were you given any prescription medication to control pain and inflammation? Your initial healing will be uncomfortable with a more difficult extraction and medication to control the inflammation will offer some relief. Prescription medication for relief may be required. Possible use of a steroid for control of intense inflammation may be recommended by your dentist. Thank you for your inquiry. I hope you have some improvement soon and recover quickly. I hope my recommendations are helpful.</s>

<s>[INST]Ive been having strange symptoms that no one has been able to figure out now for almost 3 years. I constantly have stomach troubles, constipation, diarrhea, bloating etc. I have been diagnosed with acid reflux . Specialists also think I have an autoimmune disease because when they tested my CRP level it was at 108 and my white blood cell count was elevated. I constantly run a fever of around 100 and my body and joints tend to hurt all the time. I also have psoriasis on my scalp. Ive recently been breaking out with a rash on my fingers and elbows and knees, when i looked it up it was very similar if not exactly dermatitis herpetiformis. I was wondering if a gluten allergy could be the cause of all the symptoms mentioned above?[/INST]Hello, thanks for writing to Chat Doctor. Your symptoms are definitely tough to handle, but I am glad you are concerned about your health and want to do something about it. Stomach doubles, constipation, bloating are all symptoms of a possible allergy. However, when along with skin rashes and fever, the condition definitely needs medical treatment. In regard to diet, it is possible that there can be a gluten intolerance/sensitivity. Gluten is a protein present in cereals/grains processed from wheat which is the major constituent in giving the elasticity in wheat based products. Some people are sensitive towards the gluten and hence the reaction in the form of abdominal pain, crunches etc. A gluten-free diet is recommended which is available in most of the medical shops and food outlets. Also, care should be taken not to consume wheat based products. Besides, consult a doctor to confirm if it is Gluten sensitivity before you can change your diet. Good luck to you!!!</s>

<s>[INST]I havent been taking any contraceptive pills. I am now 29 years old and my cycle usually is 34 to 38 days.. sometimes its going beyond 45 days but not more than 55 days.. for the last 4 months i have been sexually active for the first time and been worried i might get pregnant coz sometimes we do not use condom but is practicing the withdrawal method. I want to know if what pill should i take.. my last period ended last march 17.. id althea pill ok?[/INST]Hello, I have gone through your query and understood the concern. With Chat Doctor. Any combination oral contraceptive pill, especially pills like Yasmin and Althea are good for you, but, the recommendation should be done after a proper clinical evaluation by a specialist to see if you are a suitable candidate. Also, maintenance of a normal weight along with regular exercise will help to regulate ovulation and hence the cycles. Hope this helps.</s>

<s>[INST]Dear Doctor, I have been diagnosed "Mild hepatomegaly wityh Grade-II fatty liver.My fasting blodd sugar is high(150) and PP blood sugar level is normal in the range of 140.SERUM TRYGLYCERIDES:98SERUM CHOLESTROL:222LDL CHOLESTROL:142SGOT:17SGPT:27T3:1.28;T4:8.5 AND TSH:5.3.Also my nerves on the right side of the stomach i.e., near ribs swollen.I am worried about my Liver.Kindly suggest me the solution. Thanks and regardsRao.s.s[/INST]Hi thanks for asking question... Noted you have fatty liver... But liver enzymes normal range... First you have to follow strictly below instructions.... Avoid smoking and alcohol. Use very much less oil in cooking. Avoid meat, cheese, butter, pizza like trans fat for few days. Refined food avoided. Regular exercise done... Fruits more. Green leafy veg taken more... Daily on empty stomach peel one or two garlic cloves and take it that is herbal remedy that can be used... It will take few months for resolving fatty liver. Take care... Chat Doctor. </s>

<s>[INST]Hi Good Afternoon! I had a severe back pain which i could not able to bend myself. I took pain killers and also rantac tablet to get away from acidity.Now i have back pain as well i have gastric problem. I took mucaine gel now after my food. Can you guide me what can i do right now[/INST]Hi welcome to ChatDoctorI have gone through your query regarding your back stress, Dear, there are many factors causing this trouble as your age, lifestyle, food habits, exertion at work place or home, faulty posture, lack of exercise, mensuration or menopause in case of women. Adopt right posture of sitting, standing and bending to avoid stress in back. If you eat a well-balanced but simple, easily digestible diet with plenty of fibers, fish, fruits and vegetables, vitamins, minerals. You should get enough of the nutrients you need every day, but if you're not getting enough of nutritious diet, a lot of health problems hover on you, as a lifesaver, besides taking antioxidants, lemon juice with water & pinch of salt and pepper, Aloe vera juice 25 ml +AMLA juice 2 spoons, papaya, coconut water, ginger, garlic fenugreek powder 1 spoon with water, turmeric powder a level spoon with cup of hot milk at bedtime, Avoid fried, fast foods' tea, coffee, alcohol, smoking, mental stress, worry anxiety and most important is to clear you bowls. As constipation is mother of all ills. Last but not the least for proper blood circulation, regular walk, front bending exercise, yoga, pranayam-deep breathing proper rest & sound sleep, helps in detoxifying and strengthening the immune system to enhance resistance from diseases and pave way for healthy, happy, disease free life. Adopt right posture of sitting, standing and bending Do back bending exercises. Never ever do front being it worsens the situation. Bhujangasan, Khanpur San, Sheratan are best for relieving back pain. Sleep on hard bed Hope this helps solve your query. Take care All the best Mail at Chat Doctor. Com if any doubt.Don't hesitate to come back for any further query</s>

<s>[INST]I am Tanmaya , I am 29 male from India . On 2002 I have infected with Filarial disease. Initial my Dr given me DEC ( 100 Mg X 3 / Day ) for 21 Days. + Albendazole 400 MG one and Avil tab 1 per day for 21 days. I took the same the fever and pain on nerve is reduced with some small pimple like bump are appeared on the leg and poss on it. Its reduced after some days. But again and again I faced the same after 3/4 month. Again I started taking for 3 years ( DEC : 100 Mg X 3/days for 7 days + 2 Albendazole 400 MG in a Months ) . I had no swelling leg, or no big pain or regular fever. Only I have etching on the leg and if I discontinued some time slight pain or burning sensation on leg. it almost 7/8 year I have filarea. taking regularal DEC and Albendazole , there is no 100 % cure from this. Please suggest any ulternative medicine to cure 100 . I think I have some adult worm in my body. is there any medicine to kill all Adult worm . Please reply : YYYY@YYYY[/INST]Hi, Thanks for your question. I do understand your pain and discomfort. As per your history is concerned you can try like this:-1)DEC course 6 mg/kg/day, you can take 2 times per day by dividing it by 2 for 20 days and repeat after 3 months interval2)Take ALONG PLUS which contains[Ivermectin +albendazole] once a month as single dose3)Take AVID -LB 100 mg once a day for 6 weeks which contains doxycycline. Every month check your blood DC. I hope I was able to ad Chat Doctor. If you have any further questions, please do not hesitate to write to me. Wishing you all the best. Thanks</s>

<s>[INST]Herpes are starting to scar my face. also they last a long time. Suddenly my nose has 4 I recently stating dating a man who has herpes as well had this increased the odds of them on my face. We have only kissed. Hows do I treat these to make less noticable and go away quicker?[/INST]Hello dear, Thank you for your contact to Chat Doctor. I read and understand your concern. I am Chat Doctor answering your concern. Usually herpes will go with the treatment. So as if you are treated with the herpes it leaves slight pigmentation. Gradually this pigmentation will go, and skin looks like normal. I advise you should start taking the acyclovir tablet under your doctors' guidance. This is the Chat Doctor. Vitamin B complex should be taken, along with the gabapentin this all will cure the problem. Please take under doctors guidance. Avoid sex or kiss during the period of treatment. Otherwise, cross infection will occur. Frequent herpes infection is the sign of the immunocompromised status. So in advice you should test for the HIV. In HIV infection patient frequently has bouts of the infection. I will be happy to answer your further concern on bit.ly/</s>

<s>[INST]my mother is adiabetic patient for the past 12 years .she is taking pioglit for about 2years now sheis suffering from leg swelling and weight gain. her sugar level is 169 in pp. what is the alternateof using pioglit? my email id is YYYY@YYYY[/INST]**1. Side Effect of piglet [pioglitazone] is weight gain, leg swelling [edema] even with diet and regular exercise, moreover since weight is not mention thus it can be one factor for high blood sugar due to Insulin resistance.2. Check with your Doctor for possible Echo cardiogram and Lung Function test to know the health status of heart and Lungs.3. Your doctor may Stop the medicine and change it with some other option since it is banned in many countries.4. One must see a diabetes specialist, who will look clinically for:. Weight. Blood pressure. Examination of peripheral pulses on the legs. Examination of the feet: especially the inter digital spaces and soles, for infections, ulcer and sensory loss. Say NO to: Sugar, all sweets, cakes, sweetened biscuits- Chat Doctor. . Eat in Plenty: all leafy vegetables, tomato, cucumber, brinjal, cauliflower, ladies finger, soup [tomato/vegetable], butter milk, sugar-free </s>

<s>[INST]My wife is 21 years old. I had my first sex with her about one week ago. It was 9th day from the period. We had a unprotected sex. So she took a Unwanted 72( emergency contraceptive pill) tablet after 46 hours. Now she feel some pain at lower abdomen for more than 8 hours. What is the cause for the pain? Is there any chance of pregnancy? We dont want any child. Please answer me as soon as possible. I am very worried. Thank you.[/INST]Hello welcome to Chat Doctor forum, There are so many causes of pain in lower abdomen. Rupture of Graffias follicle can cause pain in the mid-cycle. But in your case you must rule out some sort of infection, which is quite common known as Honey moon infection. As she has taken emergency contraceptive pills with in the 46 hours of unprotected sex. So chances of pregnancy are very remote & it is too early to say she is pregnant. There is no test which can detect pregnancy at such an early phase. Disclaimer</s>

<s>[INST]Hi, I get a red rash on my right cheek and my face goes hot, then followed by a headache when eating certain foods. It happens with most sweets and also sandwiches. E.g a chicken lettuce and cucumber sandwich. There are other foods which also set it off[/INST]Hello, In my opinion, you are suffering from a skin condition called Rosacea. It may be aggravated by certain foods and alcohol and changes in temperature. I would advise you to avoid the aggravating factors. You should consult your Dermatologist and follow his instructions as it is a chronic condition and requires frequent physician visits. Hope I have answered your query. Let me know if I can assist you further.</s>

<s>[INST]Hi, I have query about psoriasis that is it curable? And what are the possible treatments ? Thank You In Advance. Best Regards, Harish[/INST]Well come to Chat Doctor, dear patient Harish ,psoriasis is permanent curable diseases, that must to changes in your diet, by advise of good Ayurveda physician. And diet of psoriasis is not so hard ok. and start experienced Ayurveda physicians treatment. If your psoriasis is not chronic about 8 -10 years, so it will be cured within few months. And if any problem, so u can contact our research center to cure your disease permanent. Wish u for good health contact- 09825942366,,,,09825942366. e-mail Chat Doctor. Com</s>

<s>[INST]Hello, I am almost four month pregnant with my first child and when i go to the toilet to ither urinate or have a poo i notice in the toilet a thickish white discharge which has only been happening the past week. I obviously have had discharge before but it seems to have increased when going to the toilet. What is it?? sould i be worried?? and can it harm the baby??[/INST]Welcome to the Chat Doctor .com. I honor your consult here and being your expert healthcare provider I am assigned to help you further in this case. I have reviewed the details you have given. This is normal Physiology in pregnancy and nothing seems to be wrong. In pregnancy, it is normal to have discharge off and on. What happens is the mucous inside the vagina gets thicker a bit, and there are many more hormonal changes during pregnancy affecting the viscosity of the mucous secretions inside vagina. If there is no itching in or around the vagina; no smelly discharge; then it is ok. Otherwise, it may have been a bacterial or fungal infection and needs definite treatment. If you think it is bothering you a lot, kingly discuss it with your ORGAN for evaluation in person and diagnostic labs if needed. She will help you further in this regard. I am at your disposal for expert care. You may land again to Chat Doctor .com anytime you want. We are striving hard to make the forum better for you. Healthiest Regards!</s>

<s>[INST]I m wondering what could be causing numbness of my lower lip and chin on the left side. A few weeks ago i was experiencing pain do to what i thought was my wisdom tootChatDoctoring in( it was pushing on my other tooth). that was about three weeks, then the pain went away and couple day after is when i started experiencing numbness of my lower lip and chin and its been numb for about five days know.[/INST]Hello, I can understand your concern. Sometimes an impacted wisdom tooth can compress the lingual nerve, which supplies the lower lip and chin area causing numbness in the supplied area unless it is decompressed by removal of the wisdom tooth. Impacted tooth means the tooth that cannot come put in oral cavity because it lacks physical space to come out and is stuck in the bone. You are tight in assuming that it might cause pressure on other teeth, too causing vague pain and pressure feeling. I would advise you to visit a dentist and go for physical examination along with x-ray of the left sided wisdom tooth are. An x-ray called OPG is more preferable as it presents the surrounding area and vital structures around the tooth well. If x-ray shows impaction of the tooth, I would advise you to get it removed after consultation with an oral surgeon. However, if wisdom tooth is not a problem, you should visit a neurologist or maxillofacial surgeon for further investigations such as MRI to find out the cause of the numbness. I hope this information helps you. Thank you for choosing Chat Doctor. Let me know if you have follow-up questions. Best,</s>

<s>[INST]Hi doctor, my close friends had met with accident last week and subsequently slipped into coma following head injury. What are chances of him coming out of this state? What is the duration of coma he is likely to be in?[/INST]The outcome for coma and vegetative state depends on the cause and on the location, severity, and extent of neurological damage: outcomes range from recovery to death. People may emerge from a coma with a combination of physical, intellectual, and psychological difficulties that need special attention. Recovery usually occurs gradually, with patients acquiring more and more ability to respond. Some patients never progress beyond very basic responses, but many recover full awareness. Patients recovering from coma require close medical supervision. A coma rarely lasts more than 2 to 4 weeks. Some patients may regain a degree of awareness after vegetative state. Others may remain in a vegetative state for years or even decades. The most common cause of death for a person in a vegetative state is infection such as pneumonia. Duration depends on the severity of the injury and patient general condition, often short; rarely more than 2-4 weeks.</s>

<s>[INST]I press the muscle on the side of my shin bone and it leaves an indent but eventually retracts. There is no pain. When I noticed it I had started walking about 3 miles and my shins were soar when I was done. When I was walking it would get to the pint where I could barely lift my foot because the muscle was so tight.[/INST]Hi, As there is leg pain after walking 3 miles and indentation I feel this is related to the over excitation of the neural fibers leading the muscles to contract. Also, the fatigue is setting in after walking for 3 miles. So there needs to be a change in the exercise program to improve the muscle strength and improve the endurance. The best way to do this is to learn the maximum ankle toe movements while sitting and lying position. Also doing straight leg raise to the maximum number of counts should provide a good endurance towards the overall well-being of the muscle. Hope I have answered your query. Let me know if I can assist you further. Jay In Chat Doctor. </s>

<s>[INST]hi!im having on/off sets of pain in my lower right abdomen,doctors found some blood in my urine.my lower belly,right under my navel towards right ,feels very hard,...what could it be?some doctors have sugested catscan and ultrasound...but i would like to know what are the causes for these symtoms[/INST]Hi. The on/ off pain in the right lower abdomen with blood in urine and hardness in the area you have mentioned is suggestive of appendicitis or an impacted stone in the right ureter. Ultrasonography helps to get a proper diagnosis and also the CT scan helps to confirm the diagnosis. Once this is done, and you get a proper diagnosis, a proper treatment - medical or surgical can be started. Hence, the need of investigations. This is not to misdiagnose the case. Go for these investigations ...</s>

<s>[INST]My wife is too much aggressive and talks in a very bad languages and also give abuses which a person cant lolerated at all. She refues to go the doctor and say that she has no problem . In this situation what should I do . Her behaviour with all members of my family is very bad even with her daughter and sons.[/INST]Degree understand your concerns went through your details. I suggest you not to worry much. You are supposed to know about your wife much better than anybody else. If she is arrogant and abusive, and don't listen to anybody, and refuses to visit a doctor, then you should make her motivated to do something which she likes to do. Recharging and prioritizing her mind and priorities can definitely help. Let her go for a job and enjoy. If you require more of my help in this aspect, Please post a direct question to me in this URL. http://goo.gl/aYW2pR. Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques. Hope this answers your query. Available for further clarifications. Good luck.</s>

<s>[INST]Hi I have been taking a couple of birth control pills. The first was otrycyclin lo which made me very moody and nauseous. The second was Lessina that was ok but they said they dont make them anymore so now my doctor gave me aviane I have been taking it for 2 months it makes me soooooo nauseous and gave me an appetite I just eat all the time. I hate taking these pills I am going to be 30 I have 2kids and I dont want to get pregnant for a while so can you tell me what is a good pill to take or whats the best contrasecptive[/INST]Hi and thank you so much for this query. I am so sorry to hear about these side effects. They are real and when they become unbearable, trying out other methods of contraception is advised. Beside pills, there are other temporary methods of birth control like intrauterine device, injections, implants etc. The best thing t do is to talk with your doctor so that he can evaluate and recommend an alternative method to you. I hope you find this helpful and informative. If you have more questions, please contact me and I shall provide more answers. Congrats for taking control of your sexual and reproductive life. I wish you and your entire family well.</s>

<s>[INST]my daughter is 2 years 10 months she is suffering of acute cough and cold dr. suggested her athalin 100mcg 2 puffs for 4 times for first 2 days and then gradually 1 puff twice for five days following budecort100mcg 2 puffs twice for two days then 1 puff twice for 1 month then stop. I am worried about the side effects of these doses in future.[/INST]There are no major side effects with either inhaler. You can safely use them now, and you can use them again, and again, if these attacks are repeated. However, use them under medical supervision. Decor inhalers are steroids, and you should clean the girls mouth, tongue and gums with a rinse and wash after she has been given this inhaler, as otherwise, there is a risk of oral thrush, a kind of fungus infection of the mouth. Hope this helps!</s>

<s>[INST]This is quite embarrassing, I have a hard lump on the inside of my bum cheek, which is quite sore. I noticed it about 4 weeks ago when it was really sore to sit own but after a few days the pain went away, even though the lump was still there. It is starting to get sore again. What could this be[/INST]Hi, dairy have gone through your question. I can understand your concern. You may have some piles. Or you may have fissures or fistula. You should take high fiber diet, Chat Doctor. Local anesthetic gel can be useful. Permanent treatment is surgery. Consult your doctor and go for examination 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]hi my name is nazia Kauser and I would like to see to lungs special list. I had long term chronic bronchitis lungs problem I had treatment done back in 2003 oxygen was leaking and one side of lung shrieked. but now am very poorly that infected my left side really bad pain had traveled in my toes and ankle. kind of you if you can advice me or telephone me 0000 thank you[/INST]Thanks for your question on Chat Doctor. I can understand your concern. Chronic bronchitis is progressive lung disease. You need to take regular inhaled treatment. So consult pulmonologist and get done 1. Clinical examination of respiratory system 2. Chest x-ray to rule other pulmonary diseases. 3. PUT (pulmonary function test). PFT is must know the severity of the bronchitis and treatment is based on severity only. You will mostly improve with inhaled bronchodilator (formoterol or albuterol) and inhaled corticosteroids (ICS) (budesonide or fluticasone). You should also enroll in pulmonary rehabilitation center where chest physiotherapy and deep breathing exercises are done. These will improve your lung functions and reduce your symptoms. Quit smoking if you are smoker. Take pulmonary vaccines like pneumococcal and influenza vaccines to prevent recurrent respiratory tract infections. Don't worry, you will be alright with all these. Consult pulmonologist and discuss all these. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.</s>

<s>[INST]Hello, I started taking the birth control pill on Sunday March 16th, but it was after my period had already ended. I had unprotected sex on Monday March 24th. He pulled out, but I was wondering how long it takes for the pill to become effective? And if I will be ok? Some say 1 week some say otherwise. Thank you![/INST]Hello misunderstand your concerned not worry. There is no chance of pregnancy as you did sex in the safe period of cycle (just after period). It is safe period because ovulation does not occur during this time. Contraceptive pill started to work from the first pill only, but you have to take the remaining pill regularly at the specific time for effective contraception. Just be relaxed and take you remaining tablet normally. Avoid stress and take healthy diet. Hope this may help noncontact Chat Doctor for further health query Best regards</s>

<s>[INST]hello dr i m suffering from hepatitus my alt is117 & my bliurobin is 139 from last 2 months it is still condition dr advise me liver biopsy on the report comes and it shows (openion: Chronic Hepatitis with mild active no fibrosis) i already tested my hepatitis B & C which is negative now tell me what to do[/INST]Hi thanks for contacting Chat Doctor.... Noted you have chronic hepatitis ..... Your hepatitis b and c negative.... So following can be the cause......-non-alcoholic steatohepatitis-alcohol hepatitis -alpha 1 antitrypsin deficiency-Wilson disease-autoimmune condition- Chat Doctor. ... From biopsy sections IOC or special stain can be done to rule out alpha 1 antitrypsin deficiency or Wilson dz Symptom of other systems also searched for..... If autoimmune condition present immunosuppressive </s>

<s>[INST]Hi doc, how is allergy testing done? Could you tell me more about hypo sensitization or Desensitization?[/INST]Nice to see someone interested in knowing about allergy and hypo sensitization. Allergy testing is used to identify an allergen. Skin testing is the most common method used to determine an allergen, because several allergens can be tested safely at the same time. Allergy testing is not a treatment, nor is it always accurate. You can also find out the allergen yourself in the daily life to the foods, perfumes, or the atmosphere that triggers the allergic reaction to you. Hypo sensitization is one of the two methods of treatment of allergy. Hypo sensitization, or desensitization, involves injections of tiny amounts of the known allergen. The amount of the allergen is gradually increased per injection until you are able to tolerate exposure to the allergen with only mild symptoms. Hypo sensitization takes 3 - 6 months to begin to work, and it is usually continued for 3 - 5 years. It is expensive and provides varying degrees of success, depending on the condition. Hypo sensitization usually begins when maximum avoidance and medical therapy is unsuccessful, and the allergic condition is interfering with your life, such as causing you to miss many days of school, work, etc., or requiring many emergency room visits for care.</s>

<s>[INST]hi, i have a problem related to penis,on the foreskin of my penis there is a black mark which is there for some time and not going, i applied some anti-bacterial ointments as well but it still there,and it appears like ringworm infection. kindly sugggest what to do to get rid of this?[/INST]Degree understand your concerns went through your details. Please do not self diagnose of self treat. Ringworm is a fungal skin infection caused by a fungus. Ringworm occurs when a particular type of fungus grows and develops on the top layer of your skin. The fungus infection thrives in warm, moist areas such as, under the foreskin of your penis. The infection is a common fungal skin disorder, affects people of all ages. Although its name suggests otherwise, it is caused by a fungus, not a worm. Ringworm is contagious. Ringworm can be treated with antifungal creams and ointment. But before that, you should consult a skin specialist to confirm that the problem is related to ring worm. Consult a dermatologist. If you require more of my help in this aspect, please use this URL. http://goo.gl/aYW2pR. Make sure that you include every minute detail possible. Hope this answers your query. Further clarifications are welcome. Good luck. Take care.</s>

<s>[INST]I have been sick for about two weeks now, Im not sure yet if its really bad allergies or bronchitis. I made an appointment with a doctor however, my period is about a week late and I am not sure why. I am not having any symptoms of pms or pregnancy, and usually if Im very stressed it gets delayed. I was wondering if my period could be possibly delayed because of being sick and being very stressed?ll[/INST]HI, thanks for using Chat Doctor Physical or emotional stress can cause a delay in periods. Physical stress would include feeling unwell. Other causes of period delay are: (1) inadequate diet (2) extreme physical activity (3) abnormal thyroid hormone levels (4) high levels of a hormone called prolactin (5) polycystic ovarian syn Chat Doctor. If this is negative then you can consider waiting to see if it comes. If there are any symptoms of hormonal issues mentioned above then your doctor may consider blood tests. I hope this helps</s>

<s>[INST]My name is kavit mehta and i am 38 years from india. i had been detected with blood pressure 4 years before and i was on concor 2.5 uptill today. My BP remanis 130/85 with medicine and almost in control all the time.i have recently expirenced first time problems with erection. this happens 2 times in last one week. overal desire has also decreased then before. i was also experiencing problem with urination. (but just mild straining) nothing big.. or troublesome from last few months. which if i drink water and have regular walk goes ok.My cardiologist has just changed my current medicine from concor 2.5 (once) to telma 40(once) after i explained him above. My all reports of blood, urine, liver function, kidney function, 2D echo, TMT has come absolutely normal.My question is the change in medicine is ok ? or should i take telma 20...? my weight is 78 and height is 170. Is the problem which i am facing is due to taking BP medicine uptill now ? is there a way to manage BP and stop medicine ? Is the change from Concor 2.5 to telma 40 ok?[/INST]Dear Davit Meta, It is a very good idea to change Concord to Selma. Usually I try to avoid prescribing beta blockers (medications such as Concord) to young men. You should take Selma and see if the dose is appropriate for you, as it is quite individual. You should strictly follow healthy lifestyle, and after some time try to reduce the dose of your medication. In some young patients, we succeed to with Chat Doctor. Hope I could help nourishing you good health In case of further questions don't hesitate to ask</s>

<s>[INST]I had basal cell carcinoma removed and it caused a keloid scar and I had some small veins that you could see. i had steroid injections and it is now flat. in addition I used Zyclara prier to my keloid and it made a pinkish red ring. So I had the ILP treatment done on my entire chest and including my keloid and I noticed that my keloid came back I think because it is puffy. Is that normal or will it go down from the ILP treatment.[/INST]Hi, dairy have gone through your question. I can understand your concern. You have surgery fir basal cell carcinoma. Your surgery caused keloid scar. It is known for recurrence. So no need to worry. It is a common phenomenon. Treatment options are steroids, laser treatment or surgery. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using Chat Doctor. Wish you a very good health.</s>

<s>[INST]I had a hard fall after slipping on ice 11 days ago. Very sore wrists still and sore back just around lower rib area. Waited all day and had a bone scan today. Technician said what did you do to your back - he thought it looked serious. Radiologist did not review the scan today. I waited in emergency until 7 at night to have to attending doctor tell me to go home, see my family doctor In a couple of days for results. The back is uncomfortable at night - it can be sore enough to take Pain med to sleep and feels like something is loose - I can tell exactly where the injured disc is. Should I insist on an X-ray to see sooner what the damage may be? If the spine has not been effected this past 10 days should I just wait to see my doctor with the bone scan results in a couple of days?[/INST]Hi. I suggest you to kindly get an x-ray done to rule out rib fractures...if you rule out this then you can wait for your physician appointment... In the meantime I recommend you to kindly do. Lot of icing over painful area.if you have abdominal binder can support the injured area. Avoid lying on the injured side... Take rest as much as you can...you can also get back to us with your reports... Hope this is helpful for you...Revert in case you need any further assistance in this regard...</s>

<s>[INST]My wife have been taking Illumigan for sometime because of the Glaucoma problem. I notice that since then she is forgetting certain things or don t remember what happens an hour ago but when I ask if she remembers what happens later she tells me that she indeed remember what happens. but that she temporally Ignore afraid if this is a sign of Dementia the beginning of Alltsheimmer?[/INST]Dear serve understand your concerns went through your details. Please provide your wives. Memory problems (particularly remembering recent events), reduced concentration, increased confusion, loss of ability to do everyday tasks, apathy and with Chat Doctor. Difficulty finding the right words while speaking is considered as primary. Still, expert diagnosis is essential. Do consult a neurologist for further information and treatment. If you require more of my help in this aspect, please use this URL. http://goo.gl/aYW2pR. Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications. Good luck.</s>

<s>[INST]my boy friend is having bleeding problems from his penis.sunday night while sitting atthe table he had a pain shoot from his kidney down when he got up to go pee he was drippig blood from penis and could not pee because it hurt that bad.i took him to the hospital they said he has a std and thats what they are treating him for,thats not whats wrong,he had kidney stones a couple months ago,last night when he went pee he passed a long worm like in shape blood clot.can you help me?[/INST]helloThanks for query. With previous history of kidney stone disease Bleeding from penis associated with severe pain in urethra is due to impacted stone in urethra stone rubbing against the delicate urethral mucosa to cause bleeding and not due to STD. This has been confirmed itself by passing a stone in urine next day morning. Ask him to take antibiotics for a couple of days. Ensure he Chat Doctor. </s>

<s>[INST]I have a pain in my lower back whenever I m hungry. The pain can be in the right or left or both sides. I had tests done and showed that I have overgrown bacteria. I was given Omeprazole 40 mg and Metronidazole 250 mg. It has helped a bit but the problem still exist.[/INST]Hi, Thanks for your query. After going through your query I came to know that you have pain in back whenever I am hungry. It suggests that pain is due to acidity. So regularly take omeprazole which you are taking. Also take your food on time so that acidity does not occur. You can discuss with your treating Doctor about it. I do hope that you have found something helpful. 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 was researching agent orange and blood colts in legs and saw this...my husband was in Vietnam in 1967 and 1968....he is a retired mail man and walked for 35 yrs...retired and continued to walk at least 2 miles every day except sunday...In 2008 for no reason he developed a clot in his right leg from ankle to knee...went to his lung....all blood test for clotting factors were normal....did the 6 month thinner treatment then developed another clot in left leg from knee to groin...do you think this could be caused by agent orange[/INST]Your husband has a condition called deep vein thrombosis (DVT). Some risk factors for deep vein thrombosis are prolonged immobilization, trauma, cancer etc. I would suggest the following tests to find out if there is an underlying cause for your husbands DVT. They are as follows:CBC, chest x-ray, urinalysis, liver enzymes, and serum electrolytes, BUN, creatinine. If a screening colonoscopy has not been done earlier, a screening colonoscopy is also advised. I also suggest Factor V Leiden (FVL) mutation and prothrombin 20210 (PT 20210) mutation tests. These two tests are often used together to help diagnose the cause of inappropriate blood clot (thrombus) formation, including deep vein thrombosis (DVT) and/or venous thromboembolism (VOTE). Testing for Factor V Leiden and PT 20120 mutations is used to help determine if an individual has inherited a disorder associated with blot clots. There are many research projects gathering evidence about veterans exposed to Agent Orange and their associated disease. Some studies show that people exposed to Agent Orange are more prone to develop Diabetes mellitus which over the years puts a person at risk for DVT. The medical literature shows that some individuals exposed to Agent Orange had developed DVT however more evidence is needed, and research work is going on at the CDC and other institutes. Best regards.</s>

<s>[INST]I had surgery in March, 2014. The anesthetic was in my lower spine. I had a section of my colon removed, fissure in bladder repaired, and gall bladder & appendix removed. I now have almost constant pain in my lower back. Could this pain be a result of the injection in my spine?Thank you![/INST]First you have not mentioned your age which is very important in case of back pain. For treatment take some painkiller preferably biozobid-plus or osteopath along with some calcium supplements like toscal-gem or shackled once daily. Take some multi-vitamins like metilda-forte or neurokind-plus once daily. You can do some physiotherapy exercises after an expert opinion of physiotherapy. I will also advise you to sleep on a plain surface.</s>

<s>[INST]My daughter had a lesion removed with general anestesia. Her oxygen saturation was low and heart rate high. We were released when her heart rate was 120 and her oxygen level was 98. Should I worry about her heart rate? She is complaining about naseau and vommitting.[/INST]Greetings. Welcome to Chat Doctor, and thank you for your question. I understand your concern. Well, our main concern, as doctors, as the side effects of general anesthesia. It is commonly known that a large amount of risk in perioperative period can come from side effects of anesthesia. My opinion is that this is the case. You see, during general anesthesia all the organism is controlled basically by machines and vital parameters are controlled externally. It is more than understandable that there will be a slight disturbance in organism equilibrium after weaning off from anesthesia, such as blurry vision or speech, high heart rate or low saturation, due to intubation applied during anesthesia. I am glad that surgical removal of the lesion went fine. The other effects may be easily attributed to general anesthesia, and normal gain of function is just a matter of little time. My opinion is that there is nothing to worry about, and these symptoms will abolish in no time. I hope I was helpful with my answer. Take care. Best regards, </s>

<s>[INST]29 January 2014 - 1-2 day heavy period with clotting and flu like symptoms. 21 February 2014 - 4 days before missed period = very sore larger breasts and blotting took clearblue digital test - pregnant 3-4 weeks . This doesn t add up ? How far along could I actually be ? Thanks[/INST]Hallow Dear, If you understand some basic facts of conception, your dilemma about the day of conception would be clear. The conception takes place on or within 24 hours of the egg release (ovulation) as the egg can live only up to 24 hours. The day of ovulation is 14 days prior to the next expected menses. You had your last menstrual period on 21 January and the next expected period was 25 February (21 Feb + 4 days). So your day of ovulation is about 11 February. Therefore, the day of conception would be around that day. Though clinically the period of gestation is calculated from the date of last menstrual period (LMP), actual conception takes place around 2 weeks later. This has probably created the confusion for you. Pregnancy of 3-4 weeks from the date of LMP is actually 2 weeks lesser in age. To further clarify this dilemma, you may get ultrasonography done. By ultrasonography, the age of the embryo is calculated by its size. Hence, it would be the real age of the embryo; i.e. calculated from the day of conception. However, please be aware that in such early stages of pregnancy, there could be variation by few days to a week in calculating the age of embryo. I hope this resolves your dilemma. </s>

<s>[INST]I have experienced chest pains for two weeks now on and off. during the day at work im usually okay but when i get home (usually whilst sitting on the sofa) I expirence a pain just to the left of the centre of my chest. This mostly spreads to the left side of my chest (heart area). I have had blood tests and an ECG all coming back normal but the problem has persisted. The pain can also move up to my left shoulder and bicep and up the left side of my throat. VERY worried but embarassed to tell anyone because I know its probably nothing. It is a nightmare thinking about it constantly. please advise.[/INST]Thanks for your question on Chat Doctor. I can understand your concern. No need to worry about heart diseases as your ECG is normal. Your pain is associated with specific position (sitting on sofa), so possibility of musculoskeletal pain is more likely. So avoid sitting on sofa or sit with proper back support. Avoid movements causing pain. Apply warm water pad on affected areas. Take simple painkiller like paracetamol or ibuprofen.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]I noticed a hard lump on my clavicle bone at the inside of the right side. It did not hurt but is noticeable. I m not sure if I m imagining some soreness in right shoulder and neck area because of thinking about it, but I do believe I have some minor soreness. What could be the cause of the knot and are the two related?[/INST]Hi! Good afternoon. I am Chat Doctor answering your query. If I were your doctor, I would examine the lump physically to see if it was originating from the clavicle itself, or it was a lump just adjacent to the clavicle. In the second case, it could be a lymph node swelling common in the cervical region and there has to be a primary focus of some infection or pathology for the lymph node to enlarge. So a detailed physical examination would be needed before deciding on the plan of management. Therefore, I would advise you to please take an appointment for a general surgeon in your area and get it assessed by him. Till then, you could go for an anti inflammatory Chat Doctor. I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing Chat Doctor to clear doubts on your health problems. I wish you an early recovery. Chat Doctor.</s>

<s>[INST]Hi, Thanks for your advice. I have been treated for almost 5 years for PMR which appears to not be leaving. Are there experienced doctors in the Fort Myers area that have experience with this condition? As a result of this condition, I am now having vascular conditions occurring. Any ideas would be appreciated.C.[/INST]Hi, thank you for providing the brief history of you A thorough clinical examination is advised followed by a Doppler test. As you are facing with vascular condition, you need to undergo a clinical examination post which we can actually come to a conclusion is the problems are related to any clot in the vascular system leading to abnormal signs and symptoms. In my clinical practice most cases responds well to a combination of medication and physical therapy. As most vascular conditions when treated with a combination of medication and physical therapy response is good. Also, for vascular condition exercises play an important role as with the help of exercises the muscles function better, and the vascular insufficiency can be corrected. RegardsJay In Chat Doctor. </s>

<s>[INST]Greetings doctor,I am 18 year old boy, uncircumcised. I have little bit of vitiligo. I have stopped consuming all the medicines for it now .I was prone to masturbation and did it pretty much everyday .My penis (glans) looks blue, dry and a bit brown and dark near the meatus(opening). I have very dry foreskin.I was using coconut oil as a remedy. I have a healthy diet but a bit sleep deprived routine due to studies.I have a loss of libido too. I am virgin.[/INST]Degree understand your concerns went through your details. Please understand, you must not misunderstand simple things and become anxious. Vitiligo is a chronic skin condition characterized by portions of the skin losing their pigment. On treatment the condition will be cured. You should continue treatment. You should not associate your vitiligo condition with your masturbation or sexual abilities. Masturbation is considered healthy if done in moderation. You can have one masturbation per day but not when you have skin problems. For the time being, keep away from masturbation. Coconut oil makes skin more Chat Doctor. Instead, you may use olive oil. If you require more of my help in this aspect, please use this URL. http://goo.gl/aYW2pR. Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications. Good luck.</s>

<s>[INST]my grand daughter was diagnosed several years ago with a hole in her heart. Surgery to close the hole will occur when the doctors feel she is old enough. Her and her mother are the typical boy who cried wolf complainers. (I dont mean to be harsh, but she has 3 kids and numerous times shes said they were on their death beds for non-existent conditions, just for attention.) My grand daughter uses physical complaints for attention now too. My question is, with a hole in her heart should she experience severe chest and stomach pains? when its time for bed, for instance, she will say her heart is hurting and she will throw fits and demand pain pills. (she is 8). Just wondering if this is a legitimate symptom. She is full of energy and runs around non-stop... until she gets told something she doesnt want to hear, like bed time.[/INST]Thank you and pleased to answer you there is considerable evidence suggesting association between hole in the heart or congenital heart defect and pain in the head mostly migraine. The reason for this particular association is unclear (genetic??) But medical literature reports many patients that undergone surgical closure reported a significant reduction or disappearance of migraine. Painkiller may relieve symptoms time to do surgery. May this help you.</s>

<s>[INST]I have been taking Seritide Acuhaler and Flixonase for over 10 years for what I am told is Asthma. I am choked with catarrh all the time and these inhalers don t seem to help at all. Am I better taking a daily antihistamine , as the congestion is affecting my sleep in a big way ?[/INST]HI, thanks for using Chat Doctor The congestion may be related to allergic sinusitis or allergic rhinitis which may be associated with asthma. The use of topical steroid nasal sprays along with your other medications would help to reduce your symptoms. Eg of sprays are Flonase, rhinoceros, alone, nasocortIf you can identify the source of the reaction and reduce your exposure then it may help as well. I hope this helps</s>

<s>[INST]My wife is 59. She has episodes of pounding heart beat with very rapid pulse rate. Her younger brother also has these symptoms-he is 50. This condition has been present since pre adolescence. Today during one of these events her blood pressure was 156/84 with a 94 pulse rate.[/INST]Hello and welcome to Chat Doctor, Pounding heart with rapid pulse suggests cardiovascular pathology and necessitates a cardiovascular examination. A concomitant high blood pressure is a risk factor for cardiovascular disease. Presence of similar symptoms in another family member raises a suspicion of familial cardiovascular disease. On the basis of history a cardiomyopathy is suspected. Cardiomyopathy is disease of cardiac muscle. Thus, I suggest you to consult a cardiologist for investigations and further management. Thanks and take care Chat Doctor. </s>

<s>[INST]I am leaking from my belly button and last week my blood platelet count was high. My belly button just started leaking today and my doctor said that my platelet count has been going up over the years. My also doctor thinks I may have Leukemia or a bad infection.[/INST]Dear patient. You didn't mention the color of the discharge, which is very important. The causes of discharge can be due to 1.infection of belly button region 2.intestinal infection 3.developmental defect during the closure of umbilicus. Now your increase in platelet count, if more than 4,50,000, is considered as thrombocytopenia, an indicate for cancer. If lower than 4 lack is probably harmless.in order to rule out leukemia, you blood tests will show abnormal WBC count and abnormal shaped ABCs. Does your blood test say that? If no than you donor have leukemia.</s>

<s>[INST]My serology report CMV ab-IgG 371.9 but others are negative. In histo pathology report impression : deficient secretory endometrium , Leiomyoma . I have stage 4 endometriosis also. cronic Oopharitis and salphingitis; How can I make a baby? My husband s all reports normal.[/INST]Hi Melissa, Welcome to Chat Doctor. You have not mentioned the size of leiomyoma. If the fibroid are small then in pregnancy they may not create problem, but if they are large and multiple, then even after you conceive, progress of pregnancy will be hampered by these fibroid. In that case mastectomy is advisable. You have not mentioned the patency of the tubes. If both the tubes are blocked then natural conception is out of question. You could go for Invited Fertilization, where they will ripen your ovum by medicines and when mature retrieve it and mate it with your husbands sperm and introduce the fertilized egg into the uterine cavity where the pregnancy can progress naturally. Wish you all the best.</s>

<s>[INST]almost evytime I eat anything, when my food reaches my stomach I get this most excruciating pain just above my belly button I cant sit stand lie or walk about to relieve it and no painkillers seem to help, it takes approximately six or more hours before I get any relief. I have been to the doctors and he is sending me for a test with the camera and I have had a ultra sound scan to rule out gallstones. My stomach always looks swollen and I get extremely tired and light headed.[/INST]Hi. Thanks for your query and an elucidated history. Such a severe pain on the food reaching the stomach is suggestive of a big stomach ulcer or an obstruction in the upper part of gastrointestinal system. I would advise you the following on an urgent basis::Upper GI Endoscopy and biopsy. Contrast enhanced CT scan of the abdomen. Colonoscopy. This will give the diagnosis and treatment will depend upon the findings.</s>

<s>[INST]I have a friend who has been diagnosed of being Hepatitis B positive. He has just had his profile taken and these are the results: HbsAg with titer-ECLIA method - 8,905; Anti Hbs-ECLIA - 2.0; HbeAg - 0.140; Anti Hbe (reverse) - 0.003; Anti Hbc IgM - 0.047; Anti Hbc IgG (reverse) - 0.444 Please interpret them and what can he do to prevent these results from progressing.[/INST]Hi, Thank you asking ChatDoctorHbsAg 8,905 show that he is carrier of hepatic virus B.the other exams show that he has not acute hepatitis B, but may be is chronic hepatitis B.to show if it is chronic hepatitis B, how active is the virus he should perform some other tests like ALT, AST transaminase, bilirubin direct and indirect, HBV-DNA, abdominal ultrasound. After that he should consult a Castro hepatologist to decide if he has chronic hepatitis B, and if he should start anti-viral treatment. All the best Chat Doctor. </s>

<s>[INST]My mother is on a beta blocker and says she is always tired. I have noticed (and I am a Nursing student) that she looks pale/pallor. Is this a side effect? Does she need less medication to perfuse her Cardio system? It seems as though her cells are not being oxygenated enough. What do you think? She is 56; 145 lbs; HTN (stage One); Hx of situational anxiety. Thank you![/INST]I read your question carefully, and I understand your concern. Beta blockers can at times excessively slow heart rate or lower blood pressure and lead to weakness and tiredness. However, that is easily established by measuring blood pressure and checking her pulse and measure her pulse rate which can be easily done at home. If rate is over 60 beats per minute and blood pressure is not low then I do not think that the beta blocker is the cause. In that case other possibility should be looked at starting with anemia, liver and kidney conditions etc. For that some routine blood tests for blood count, glucose, liver and kidney function, electrolyte panel are advised. I hope to have been of help.</s>

<s>[INST]hi my name is nancy i have a daughter who has high blood pressure and problems with her thyroid she is only 21 and has had these symtoms for about 2and a half years no one can give use any answers to why this is happening i hope hope you can help no one else has been able to help her cardiologist has run every test every blood work there is and no answers please help my daughter thank you nancy sheridan[/INST]Hello, Thanks for the query to Chat Doctor. Forum. No doubt hypertension is there, but it is not necessary that, hypertension is due to heart problems, so, how a cardiologist will diagnose the disease. As you mentioned in query that there is problem with thyroid, but what type of problem, mention it? Please upload the value of T S H, T3, T 4. Certain thyroid diseases develops very high blood pressure, so report is very important. Hope I have answered your question. If further any question I will help. Good luck. </s>

<s>[INST]Hi, My 4 yr old daughter has a lump on the back of her earlobe. It is very painful and when I drain it alot of pus and blood comes out. Just when I think it is gone it fills up again. What could it be? She had her ears pierced 4 months ago, but the lump is not on the piercing.[/INST]Hi Dear, Welcome to Chat Doctor. Understanding your concern. As per your query lump in the earlobe of your daughter is mainly due to infection of the ear lobe or due to parotid gland swelling. I would suggest you to take a combination of Antibiotics/ antihistamines. Apply Voltaren Gel locally. Gargles with Listerine antiseptic mouth wash. Take Tab Zirconia to fasten the healing. Give your daughter hot fomentation. Symptoms will resolve in one week. If symptoms keeps on persisting visit ENT specialist once and get it examined. Once a proper diagnosis have been made, start treatment accordingly. Hope your concern has been resolved. Get Well Soon. Best Wishes,</s>

<s>[INST]I treat with a gastologist that I am satisfied with. I have pancreatic dyfusion. I have had sugery on my pancrease twice, I believe the tail and part of the body was removed because of cyst. I am getting to the point where a lot of foods cause pain in the upper right abdomine and upper right back. The doctors at U of M (Michigan) has the gastrologist keeping an eye on my pancrease by doing a MRI every 6-12 months. Is there something special I can do to help maintain the discomfort. I do not feel I am in enough pain to have it removed and deal with the consequences of that. I also have acromagely which is another issue in it self. Its a good thing I see the glass half full.[/INST]Hi and welcome to Chat Doctor, thank you for your query. You can take painkillers and change dietary habits, these are only possible remedies at this point. The last option is surgery, but it can always be done. Eat less fat food and more frequently in smaller meals. Also avoid high sugar food and Chat Doctor. There are certain medicines which decrease pancreas secretion so consult your doctor about it, it is called somatostatins. Wish you good health. Regards.</s>

<s>[INST]My mother Serum Creatinine is 2.2 nad hb is 8.1 at the moment and doctor is giving one tablet renolog + one injection epocept 4000 U follwed with shelcal and olsar 40 (for BP) + matilda,, so i want to know how critical her disese is now...as i am not getting what is d best to get her improved or are we on right track with these medicinesMother age is 61[/INST]Hi, I had gone through your question and understand your concerns. Looking at her creatinine level I can tell you that the disease is not that critical does need dialysis at this time and medical management which you are taking is sufficient. If she is my patient I will definitely do the same, and you are on the right track with those medications. Please keep an eye on the creatinine level do regular investigations and make sure the creatinine won't go high.</s>

<s>[INST]I sometimes find it difficlut in getting erceted and therefore cannot perform sex to my satisfaction. Could you please let me know the cause and how to treat it to make me perform better.<Your earliest reponse to my request will be very much appreciated.Jonathan Addy.[/INST]HelloThanks for query. The problem of erectile Dysfunction that you are facing is mostly due to what is called as Performance Anxiety. Following measure will help you to boost up your confidence and getting good erection and delay ejaculation. 1) Practice regular exercise for 45 minutes followed by meditation for 1/2 an hour in the morning. 2) Take high protein diet rich in vegetables and fruits and vitamin A, C,D, E.and Zinc 3)Take anti oxidants like Almonds 5-6 everyday4) Avoid alcohol and smoking. Taking Sildenafil (Viagra) or Calls as on demand will help to get good hard sustainable erection and to have enjoyable sex. Chat Doctor. </s>

<s>[INST]My Child age of 27 days. Physically he is fit normally. He takes his mothers milk usually. my child is male. At the time of delivery some problem on his head as like soft and soft on the back side on his head. at once we are taking advice and Homeo medicine, the problem has solved. Now we are seeing that my child s navel is soft (like Khaca) but not out pouse. at this fact what can I? Recently, His mother is weak physically. in spite of take some Vitamins, lime calvo-, D Bextram, Zip-CI according to SP. Doctors. But she does not feel well. Now what Can I? what is your advice. As she is feeling unwell, So we are taking a lactogen can any problem? Pl advice about my child and his mother.[/INST]Thanks for putting up your query at Chat Doctor. Congratulations on having a baby. You have not mentioned how your baby was born i.e. whether by normal delivery or by cesarean section. If he was delivered by normal delivery, may be that during the delivery some amount of blood was collected under the scalp, what we call scalp hematoma. It goes away on its own and is not a cause for worry. I do not know whether the homeopatChatDoctoredicines have given any additional relief. The umbilical cord generally falls off in 7-15 days and initially may remain soft. Some antibiotic ointment like Newsprint may be used there. If the umbilicus or navel is in Chat Doctor. Coming to the case of your wife, she had to bear a lot of hardships during pregnancy as well as labor and delivery. It is natural for her to feel weak unless she gets adequate nutrition. She needs a healthy diet to help her body to recover. And she needs to eat for two people, not one. Through her milk, her baby gets what she eats. Vitamins are not going to do much good as they are required in very small amounts and the things she needs more are things like carboy</s>

<s>[INST]hi i have 6 and half month old baby who is suffering from loose motions for the last more than 1 month inspite of many treatment from different doctors it is not possible to stop his liquid some loose motion can u suggest or advice some treatement, remedy or precautions[/INST]Hi. I had gone through your history. I understand your concern. Actually, the correct treatment we can prescribe when we know diagnosis. We should find cause of diarrhea, it is symbiosis caused by pathogenic flora. For confirmation of diagnosis I suggest stool culture for flora and sensitivity to antibiotics, stool analysis, stool for cyst and ova, blood test, Igg to G.labials. I usually prescribe antibiotics or bacteriophage according to results, enzymes syrup, probiotics for 1-2 months for normal flora. Give analysis, then lets me know results.</s>

<s>[INST]Hello Doctor,I had 3 abortions in last 3 years and one ectopic pregnancy..I am going for IVF now but 2 time failure implantation so doctor has advised to AKT4 for two months will I be able to concive after 2 months is this treatment safe in pregnancy?are there any side effects of this treatment?[/INST]Hey thanks for your faith in the Chat Doctor.I have gone through your question and understood your problem. Yes, it is sometimes possible to have tuberculosis, and yet test negative on the conventional laboratory test. Evidence of tubercles directly seen on DL and hysteroscopy is the best proof of genital tuberculosis.She is right to recommend anti-tubercular treatment for you, based on the directly visible evidence. It is definitely possible to conceive a baby while on AKT. Just wait for the initial two months of AKT 4 to get over. Then you can start trying for pregnancy. If the tubes are open, there should be no hitch there. There is no complication to the baby while you are on AKT 3. Hope I have answered your query. If you like my answers and wish me to answer in the future, bring it to my attention</s>

<s>[INST]My grandad is 78 years old and the victim of 6 major strokes. He has a foley which has caused a uti that put him in the hospital. While there we found out that the bottom half of his heart is dead and the part that is still working is only functioning at 20 %. They took him off his blood thinners for the next week so he can undergo surgery to put a catheter directly in his bladder . What kind of survival rate does he have?[/INST]78 yrs old male with diagnosis of stroke, uti, poor LV function planning for supra public catheter things look in very poor condition but still better care and treatment management can make a hope investigation almost done check for multiple organ functioning properly or notional FUNCTION TEST LIVER FUNCTION TEXTBOOK SUGAR TREATMENT OR MANAGEMENT1)POOR LV FUNCTION MEANS MINIMUM IV FLUID ACCORDING TO CENTRAL VENOUS PRESSURE2)CONTROL BLOOD PRESSURE, BLOOD SUGAR3)PROPER HYGIENE CARE OF PATIENT 4)CHECK FOR FEVER IF PRESENT THEN DO FULL WORK OF IT MP, WIDAL, SPUTUM CULTURE AND SENSITIVITY, URINE CULTURE AND SENSITIVITY, BLOOD CULTURE AND SENSITIVITY5)PROPER ANTIBIOTIC COVERAGE6)DAILY CARDIOLOGIST OPINION FOR CARDIAC FUNCTIONING MANAGEMENT</s>

<s>[INST]hello Doctor does I am 24 yrs ,I started Masturbation daily when i was 19 yrs.now the problems is left side of my body is in good shape but the right side of my body is out of shape..is due to masturbation.. please conform it...if the problem is not due to masturbation than guide me what should i do.[/INST]HelloThanks for query. Based on the facts that you have posted you have been indulged in masturbation since many years and now facing problems related to general health like left side of your body being stronger than the Rt side. First there is myth in a mind of common man that excessive masturbation is the reason of all sexual problems But I would like to state that it has been discussed in scientific forums all over the world and proved scientifically that masturbation does not have any negative effect on any organ or system in the body. All the problems that you are facing now are mind related and due to anxiety. Following measure will help you to boost up your confidence and getting good erection and delay ejaculation. 1) Practice regular exercise for 45 minutes followed by meditation for 1/2 an hour in the morning. 2) Take high protein diet rich in vegetables and fruits and vitamin A, C,D, E.and Zinc 3)Take anti oxidants like Almonds 5-6 everyday4) Avoid alcohol and smoking. Chat Doctor. </s>

<s>[INST]Hello There Here is my Dillemma and what I have been dealing with for years. I am 31 now. This has been going on since early 20s Constant left Chest Pain. Feels like a Dull Ache that sometimes is tolerable but sometimes it flares up to a stinging, Burning muscle spasm. For the last 3 to 4 years years i have been to the ER on multiple occassions. Always get the Nine Yards EKG, Chest XRay, Blood work. Everything checks out great, Im discharged. Last visit was this week and the time before was in August. In then many times over years. I saw my primary care doctor who is a lung specialist as well. Gave me a full physical and at the end said im Healthy. 8 months ago i was diagnosed with a Hiatal Hernia and Acid Reflux. I probably had that for years. It causes Weird Symptoms. My GI Doctor thinks im experiencing the symptoms she diagnosed me with. It is very frightening. My Primary care Doctor gave me Carefate this week and my GI Doctor gave me Dexilant. I have had this awful sensation in my chest and at times i rather have my leg hurt all day, Nobody thinks I have a Cardiac Issues and give me clean bill of health. Could this be Stress and Axiety, It makes me panic for years :-/ I need some assistance please! Hope all is well Mike[/INST]Thanks for your question on Chat Doctor. I can understand your concern. Hiatus hernia can cause all the symptoms described by you, so do not worry and continue your treatment as prescribed by your GI specialist. Also eat small frequent meals instead of large meals. Exercise regularly, do not lift heavy weights, keep your head end elevated by 2-3 blocks or pillows, give a gap of 2-3 hours before you sleep after your dinner. Don't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks.</s>

<s>[INST]Hello Doctor,I was suffering from jauindece from last one month I get my LFT done today my reports are Bilirubn 1.1 , Conjugated 0.5,unconjugated 0.6,AST 91, ALT 201,Alkaline phosphate 74,Total protein 7.3, Albumin 3.9, Globulin 3.4 I want to check if these reports are normal and what I have to do to reduce my Bilirubn .I am having boiled food with no fats right now. and in Drugs UDILIV 300mg[/INST]Hi, Welcome to ChatDoctorIt seems that you are suffering from viral hepatitis, and you are already on the path of recovery. It is advisable to take normal diet as many restrictions in diet are not required and patients usually follow restrictions by themselves which many times cause nutritional deficiency and lack of energy. Sometimes weightless. Just take normal healthy diet, safe potable water and fruits, if your doctor advises vitamin supplements. You will be alright soon. Good luck</s>

<s>[INST]Hi, I found out that I m 5 weeks pregnant about 4 days ago. I was having slight pains in the abdomin area. So I went to the hospital and turn out I was pregnant. Dr. recommended a vaginal ultrasound and ever since I ve been itchy and my inside is red and swollen. Is this normal? I m very quite worried. Also I have been discharging white liquid that turns into white cottage type. I need help in what this can be.[/INST]Hello, I have gone through your query and understood your concern. The origin of your present complaint dates to the time of your sonogram. Your symptoms do suggest a fungal vaginitis. This has perhaps been caused by the instrumentation you had during the sonogram or improper cleaning later on. You should immediately see your health care provider, get a proper examination and initiate treatment to control the infection. Vaginal medication is preferable since you are in the early stages of pregnancy and antifungal medications are not advisable orally. Do not douche or use strong soap solutions; use lukewarm water to clean the genital region. Hope this helps.</s>

<s>[INST]Hi I have received reply from dvla regarding my medical, as I refused to give breath speciman last year. They say need more information from my GP, I duly contacted him and he has assured me that I should get my driving license back. Apparantly my liver gamma count was 70 I am not sure about other results . I am very worried now that dvla will refuse my driving application I am a 62 year old widow and lead a very active life I do not smoke but enjoy a couple of glasses of red wine. I regard myself as fit and work part time. Losing my licence has made life very hard as I live on my own. I just want to move on with my life and I am losing sleep now terrified I will not get driving license back in September help !!!![/INST]Hi and welcome to Chat Doctor. Thank you for your query. I am Chat Doctor, I understand your concerns and I will try to help you as much as I can. It seems like you have fatty liver and there are two main types of fatty liver disease, so treatment depends on this: Alcoholic liver disease and Nonalcoholic fatty liver disease. You can get alcoholic liver disease from Chat Doctor. It can even show up after a short period of heavy </s>

<s>[INST]Hi, I m 30 yr old and my husband is 32. We are trying for baby simce 4 yrs but no success. Both of us have normal reports. Dr says it unexplained infertility. I m using Ovulation predictor kit. My ovulation days fall within 14 to 18. My period start with 2 or 3 days of spotting. Is this a problem?[/INST]Hi, Thanks for writing to Chat Doctor. Spotting Is not cause of infertility in your case. In case of unexplained infertility the causes will be problem in sperm penetration and implantation which can't be diagnosed. I would suggest you to go for ovulation inducing Chat Doctor. This will help multiple follicles to mature and rupture. With that go for GUI since you are trying from 4yrs. GUI is intrauterine ingestion of sperms. Here sperms are washed and processed, and healthy sperms are placed in uterus. This will avoid sperm ascend problem and helps in sperm penetration. You can try 3 to 4 cycles of GUI before proceeding further. Hope I have been helpful. Regards</s>

<s>[INST]I AM 35-38 YEARS OLD SUFFERING FROM BROCHTIS ASTHMA , FROM THE AGE OF 12 YEARS I HAVE SINUS THEN LATER LEAD TO BRONCHOTIS AND NOW IT IS COMBINED as BRONCHOTIS ASTHAMA -TRIED FOR SEVERAL WAYS OF MEDICATION BUT OF NO ERADICATION - DOCTOR SAID -MY LUNGS FUNCTIONING HAS COME TO 30% ONLY . IAM USING MONTEXT -LC DAILY ONE TAB, ABPHYLINE CAPS-1 CAP ALSO SPACER MOUTH SPRAY 2 PUFFS-TWICE ADAY. SHALL I CONTINUE- AND HOW LONG -IAM PUTTING ON BODY WEIGHT-IS IT DUE THESE MEDICNES, PLZ LET ME KNOW. THANK U SO MUCH, PLZ MAIL: YYYY@YYYY INDU.[/INST]Hello Hindu, Welcome to Chat Doctor, and thank you for writing to us. Your symptoms and progression to difficult asthma is a story shared by many and is the natural progression of allergic rhinosinusitis to asthma. You must ensure allergies are checked either in the form of skin prick testing or specific IGE against the extended aeroallergens/inhaled panel. If specific allergies are identified, then you need to optimize the asthma control witChatDoctorbined inhalers (long acting beta 2 agonists + inhaled steroids) like Symbicort or Sere tide and continue on Monthly. Immunotherapy against the inhaled allergens is currently the most effective way of preventing allergic progression and occasionally combined with antigen therapy (Omalizumab). The antigen therapy is quite expensive and would depend on where you are now or how easily you can get or afford it. This must be given by physicians experienced with antigen therapy. I hope this helps. Best Wishes.</s>

<s>[INST]35 year old male - otherwise in good health. On no medications other than what was perscribed below. I was diagnosed with strep about 2 weeks ago and given 5 day supply of azithromycin 500 mg tablets because I m allergic to penicillin. Felt pretty good after the 5 days and returned to work/normal activity. I woke up this morning with the same symptoms from 2 weeks ago and tested positive for strep again. This time I was given biaxin. Take 2 500mg pills once daily for 10 days. Will this clear up strep once and for all? Tired of feeling like this. Anything else I can do? Have a preemie 21 month old at home too and trying to keep him out of harms way while getting better.[/INST]Hello, Are those tongue bumps as same cloud as tongue or any other color? Is it painful, difficult to eat due to irritation? Usually color changes due to irritation, stress, hormonal changes and viral fever. Usually color changes to red or white. We don't have to do any treatment for the above described tongue bumps because they would go on their own. Are those tongue bumps very painful? If so, it cane an authors ulcer. Those ulcers also would disappear on their own. If those ulcers increase in size and also make it difficult to swallow, we have to see our doctor for topical creams. Hope this helps, thanks.</s>

<s>[INST]?. My father-in-law has emphysema, very thin (125 ish),on lots of medication,recently trouble with fluid in lower legs. Low O2 blood levels, Just started full time oxygen. But my question is..Heart rate of 130 at most of the time? (Also just stopped smoking because of the O2). Is the heart rate part of the process or is it a preventable issue?[/INST]Hello, Thanks for writing to Chat Doctor, I am Chat Doctor. Let me tell you some basics to understand, blood carries oxygen and heart pumps blood to all parts of the body to supply oxygen to the farthest parts of the body. When there is low quantity of oxygen in the blood the heart has to pump more times per minute to supply same quantity of oxygen to the tissues. Yes in case of low oxygen saturation in the blood faster heart rates are normal to find in the patient. It is definitely preventable by taking measures to treat the underlying issues, that is respiratory failure in this case, if you can correct the respiratory failure and oxygen saturation of the blood goes back to normal the heart rates will get back to normal automatically. I hope this answered your question, If you have more queries I am happy to answer you. Regards.</s>

<s>[INST]My daughter is 9 months old, about a day ago a bunch of red dots started to cover her body, like hives , she doesn t have a fever and they don t seem to bother her she hasn t scratched at them at all. It s on her arms, legs, face and around her private area kind of. Is there anything I can give her to make them go away ?[/INST]Hi... Thank you for consulting in Chat Doctor. By what you quote it should be an urticaria or a simple skin allergy. You can use HY Chat Doctor. Most important thing to be remembered is that it has a propensity to recur (called as second crop) within 10-14 days. If this happens, you can start using the same medicine, but I suggest you get the kid evaluated with your pediatrician. Hope my answer was helpful for you. I am happy to help any time. Further clarifications and consultations on Chat Doctor are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health. Regards - </s>

<s>[INST]Im a pcos patient, dr told mi to get metformin and clomid so i went to pharmacy and ask for it and they gave diaformin(metformin hydrochloride), i want pregnancy for 4 yrs so i need your help if i take this dose will i be getting positive ans.. Tank you[/INST]**1. Informing/metformin are same and is prescribed to those with high blood sugar [diabetes], and is often seen/observed in women with PCs who have insulin issues which affect weight gain and fertility. Closed [camphene] is a fertility Chat Doctor. 2. Because PCs can occur independently or secondary to other disease thus do check with your thyroid profile [under active thyroid], and since PCs is due to low metabolism (digestive fire) thus </s>

<s>[INST]4 hours ago I started to get a tingling feelng and numbness in the fingers of my right hand, then it spread to my whole hand then my lower right arm. It feels like it is subsiding slowly. I have never experiecned this before and I otherwise feel ok. I am 52 and quite fit.[/INST]Hi, Thanks for writing your query. After reading your post, it seems that your symptoms might be due to cervical spondylosis. This may be associated with pain in neck and shoulder region. You should follow some precautions like :-1. Avoid thick pillow. 2. Avoid lifting heavy weights. I would also advise that you should get yourself clinically examined and investigated by a Neurophysician. MRI of head and neck region will be helpful. I hope this is helpful to you. Thanks.</s>

<s>[INST]How to prevent sex dreams and sperm leakage while sleeping. hello Drs.Thanks for this service.. Weekly 2-3 times I m getting see dreams and sperum coming out automatically..after that I can t sleep and feeling so tired..I m getting married in couple of months..I got feared whether it will impact my future life..because I have to satisfy my girl.and sperum is very important in life..please help me to stop this and advise me to do better life.[/INST]HelloNocturnal emission of semen is normally seen in many males. It is not a serious issue. It will not affect your future life. It may be due to overexcited state, excessive fantasy, inadequate emptying etc. You should avoid provocative literature and videos. You should try to be calm and try to engage yourself in your job. If condition persists the may need psychological counselling. Get well soon. Take Care Chat Doctor. </s>

<s>[INST]yes i m an sle patient since 2008..i m hsving steriod 4mg, mofitil.500mg. last august i hv given rituximab injection. but from last month i m having severe pain in whole body..my name mrs reshma banu age 30. weight 66. pls sir advise me wht to do i m helpless now..[/INST]Good evening freshman. As I see your medications, you are on a very low dose of steroids and mycophenolate militia, the dose which we use when SHE is silent. There is a good chance that the disease had been controlled initially by Rituximab, but now it is flaring up again. Kindly consult your rheumatologist. One need s to see if SHE is flaring again or is it something else. Do take vitamin D supplements. That would help your body ache a bit as well. Hope the information was useful</s>

<s>[INST]Gm. Dr.,I woke up this am with (r)side abdominal pain. I noticed bright redblood on the tissue again. I realized it happened yesterday wo. Pain. I thought it was my menstrual. I am under a heat pad and now questioning what in really going on. W a hx of bleeding cyst and a dx. of fibroids, I am a bit concerned.[/INST]Hi. Thanks for your query. Read and understood our problems. The cause of right sided pain with blood on wiping paper can be Stone in the right ureter. This causes pain on the right side as well as causes blood to appear in the urine. This is not your menstrual bleeding, nor is it relate to the bleeding cysts or fibroid. I would advise you the following:Ultrasonography and X-ray of the abdomen will confirm the diagnosis. Intravenous paleography to confirm the functioning of the kidney. Consult Urologist for further management which may be removal by Ureteroscopy or lithography or open surgery. This also helps to rule out other causes like colitis, Ovarian cyst or appendicitis with UTI</s>

<s>[INST]hi Ive had this sickness for roughly 3 weeks now and it mostly happens after eating its starts of with a tingling sensation running from my legs to my head and then i get either a hot or cold flush then i feel like im about to be sick but never am its a really uncomfortable feeling and Ive been to my doctors and they said it could be some sort of panic attack but im not so sure about that if you could help i would be so grateful.[/INST]Hi there ~ It is not uncommon to have this feeling of hotness or feeling flush after a meal, particularly a spicy or a heavy or an unusually warm one. Everyone's physiology is different. However, if you feel that it is unusual for you and that it is causing you discomfort in any and every situation, I would recommend that you see an endocrinologist first since it could be hormonal. If you have ruled this out, an unusual form of anxiety disorder may be the case. However, you would need to consult a psychiatrist for a detailed evaluation. I hope this helps. Take care and have a safe day !</s>

<s>[INST]i have been on depo injection for a little over a year. last shot taken was may and should have expired last august. i have not had my period since. my OB prescribed 10 mg provera for ten days but it did not bring in a period. after a transvaginal ultrasound reveal thin endometrial lining .19cm, but otherwise normal ovary and uterus. January was prescibed again 10mg provera to be taken in ten days. currently on the 6th pill. is this the right way to bring a period? we re currently actively trying to conceive for baby No. 2.[/INST]Hi, Thanks for your query. I read your query and understand your concerns. Following is my reply: Since you have thin endometrium there might be difficulty in getting periods. If you don't get periods by proverb this time, ask you gynecologist to prescribe estrogen tablets next time along with progesterone which will help in endometrial growth and hence bring period. I hope I answered your query. I will be available for any follow-up queries you have. Chat Doctor. </s>

<s>[INST]I believe I have bells paulsy because I have all the same symptoms but I haven t seen anything about lumps and I have one tiny lump under the skin behind my ear and another under the skin in the mid of my neck. What do you suppose that is? The bells palsy began with a swollen ear but I understand that it can also be cancer. What do you think?[/INST]Hello, Bells palsy is by definition a paralysis of the nerve that controls the movements of your face whose because we don't know, but we often blame it on a virus. The symptoms of Bells Palsy are as follows: Half of the face will gradually (usually over several hours) become paralyzed. People often realize this either by looking in the mirror, realizing that one of their eyes is not closing or that they are having trouble Chat Doctor. There may also be changes in taste, where taste in half of the tongue is diminished. The symptoms are hard to notice though since the taste receptors in the other half of the tongue are still functional. There may be sensitivity to sounds and the muscle that helps dampen loud sounds in the ear becomes paralyzes as well. There are usually not external signs other than nerve paralysis, meaning that there should not be any swelling, pain or tenderness anywhere in the face. What you are describing sounds more like an infection or some sort of inflammation because you are having swelling in your ear. The lump behind your ear may be a lymph node that is swollen as there is a collection of lymph nodes behind your ear. I would say cancer is lower on the list of diagnoses, but based on the information I have and lacking a physical exam I cannot rule it out entirely.Nonetheless you should go see your physician to get a proper physical exam which would include a full neurological exam and an exam of the Head, neck, mouth, ears and nose to identify any possible causes. Imaging may also be necessary in which case an MRI would be the best choice without and with added contrast to visualize infection and growths better. Routine blood work would also be recommended including a complete blood count with differential, complete metabolic panel and an ESR to evaluate for signs of infection. Depending on the physical exam, other tests may be necessary. Hope I have answered your query. Let me know if I can assist you further. </s>

<s>[INST]My Grand daughter who is 11 yrs old has had a high fever of 102 to 105 for 7 days with Grand maul seizers they have done every test out there from spinal taps to brain scans .. Mono .. but still no answers they have said it to be viral i am not convinced can a High fever for that long be Viral[/INST]HI Thanks for posting your query. Yes even I agree with you, Viral fever will not cause such fever lasting for 7 days. But there are so many bacteria that testing can't be done for each and every bacterium. I need to know what all tests have been done including any scanning. Kindly Upload all the reports so that I can go through it and advise you better. I also advise doing / repeat Blood Cultures (Aerobic/ Anaerobic and fungal). Also, after taking samples for blood cultures ask your doctors to start her on Broad spectrum Antibiotics. Kindly revert with reports I asked for.</s>

<s>[INST]Hello! I am 2 and a half weeks postpartum after a healthy pregnancy... I am having swelling in my armpits on each side 3-4 different pea to nut sized balls have formed what seems like overnight. I have been having night sweats since the birth of my little girl and had a migraine yesterday... was finally able to go to sleep - more sweating. The balls hurt very badly and do have small pockets of pus right now? Any idea what this may be? Would Bactrim be the antibiotic to help clear this up?[/INST]Hi, dairy have gone through your question. I can understand your concern. You may have some inflammatory lesion or abscess formation. You should go for examination. Then if needed to take antibiotics according to your gynecologist advice. Don't take any medicine without advice because it can excrete in breast milk and harm your baby. 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]Hi. Im Al and I was hospitalized in September for 10 days for multiple PEs in my legs and lungs. My INR during the past month has been 3,2, and yesterday 1.8. My doctor upped my coumadin from 3.75 for only 2 days a week and 7.5 for the other 5. Is there a reason why the INR keeps dropping? Thanks[/INST]Hi, dear. I have gone through your question. I can understand your concern. In case of pulmonary embolism you should maintain your INR between 2 and 3. Effect of warfarin is decreased in your body. So we have to increase dose to maintain the level of INR. There are many causes for reduced the effect of warfarin. You may have some Chat Doctor. So just need to increase the dosage. Go for repeat INR test after a month. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using Chat Doctor. Wish you a very good health.</s>

<s>[INST]I am infected with HCV geno type 3a. My age is 28 and just 4 month before I came new new about HCV by test. Please can you tell me that should i keep going gym or not for exercise? what gym exercise have effect on hcv? I did not take any treatment but start to take vitamin E 200mg per day and Silimarin 210mg per day. Thanks.[/INST]Assam album. Thank you for posting query at Chat Doctor. Your diagnosed with HEPA.you need NOT worry. HEPA can be cured completely now. There are Chat Doctor. Exercise maybe discontinued if your Liver enzymes (ALT; AST) are 2 to 3 times the upper limit (means>100). it's better to let your liver enzymes return to normal, and then you may continue to go Gym. However, you may walk daily. You are also advice a special diet (fat free). Avoid alcohol and take rest. </s>

<s>[INST]Hello, I know this is probably unlikely but I heard it happens. I had sex while I was on my period 7 times and I had stopped my period three says early, he had spermed inside me each time we did it. By any chance could I be pregnant? Thank you for your time.[/INST]HelloThanks for writing to us with your health concern. Pregnancy while you are menstruating is virtually unheard of. For pregnancy to result, fertilization of the egg by sperms should occur. For this to technically happen, the female should be ovulating. Ovulation, that is, release of a mature egg, occurs each month during the middle of a cycle. If your cycle is of 28 days, it occurs around day 14. Hence, during periods, this is impossible. Anecdotal reports exist, but then that's rarest of the rare. The ovum also survives for no more than 3 days inside the peritoneal cavity. Hence, please stop worrying. Even if ejaculation occurred inside, there is no way you can get pregnant. So please stop worrying. Just to be on the safer side, you can go ahead and take a pregnancy test if you skip your period / have an altered period.However, it is quite unnecessary.In the future, please have protected sex so that infections / pregnancy can be prevented. All the displease feel free to discuss further by writing in anytime at -http://doctor.ChatDoctor .com/doctors/ Chat Doctor. </s>