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<s>[INST] my grand mas report is as per follow:phalets low , swollen is found in temparal part of brain , in urine - urea is fluctuatin in between in 72 to 103 , creatinine is 2.8.are doctor says pencreas is nt workin and kidney is infected .blood sugar : 214.case history :she caried by-pass surgery in the year 2008.she is a patient of high blood pressure and daibetes.please, advice what should done next? [/INST] Hi and welcome to Chat Doctor. As a specialist, i can understand your anxiety. Your grandmas condition is quite critical. She has multi organ involvement, with brain, kidneys,pancreas and heart being affected. Each of these organs function, has to be monitored closely.She'll need to be in an intensive care, with a ventilator facility and an intensivist ideally. Her blood routine, LFT,and electrolytes will need to be monitored closely. Along with mannitol infusion, shell need insulin and a broad spectrum antibiotic. Hemodialysis may be needed, if deterioration occurs. So, you can understand that treatment should be in a tertiary center. Chat Doctor. Manga. </s>

<s>[INST] yes my left testicle started to hurt also it gets red and swollen it feels like a mass on upper left of the sack now pain has moved into both feels better in morning I walk a lot for work pain goes to my groin area and lower stomach. when I sit or lay down pain starts to go away. I have been on cipro for a 4 days but no relief yet what do u think [/INST] Hello need proper clinical examination and routine investigations. Investigations include routine hologram, random blood sugar, ultrasound and color Doppler of scrotum, urine RE/ME. Your symptoms may be due to many causes like epididymo-orchitis etc. Ultrasound of scrotum is important due to swollen feeling of testis associated with redness. It can assess many conditions in testis. Proper treatment depend upon findings. Get well soon. Take Care Chat Doctor. </s>

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

<s>[INST] I recently (not 72hrs ago) received a horsefly bite on my ankle - and as of approx 24hrs ago, there is pain in the ankle and now swelling around the ankle. The bite does not appear to be infected (white-ish or raw) but is in the central area of swelling: The bite came while I was in remote woodland country ... any concerns or have I twisted my ankle somehow [/INST] Hello dear, Thank you for your contact to Chat Doctor. I read and understand your concern. I am Chat Doctor answering your concern. It is the allergic reaction occurred because of the horse fly bite. I advise you should take cetirizine tablet and prednisolone tablet for the allergy. Take the tablet for three days under your doctors' guidance. Maintain good hygiene by frequent cleaning and Chat Doctor. This will prevent infection and helps in healing the wound. Also avoid injury to the wound. Wear cotton undergarments this can help in prevention infection. I will be happy to answer your further concern on bit.ly/ </s>

<s>[INST] My mother always cry whenever she is alone and also have a problem of high blood pressure, gas & stone in stomach. She likes to talk to others and dont want to work anymore because she think that she is physically weak. She always think negative and used to recall all her bad memories of life in the mean time.In our family, My father is usually busy in work, my brother is busy in his studies and i am pursuing my higher education which will complete in next year. As no one is with him thats why she is very depressed and she always tell that she want at least one person to be always with her but one thing positive about her is that she believes in God and like to spend more time on religious stuff.I want her to be always happy, whenever i make a call she told me that, she is fine but she used to cry at least 2 times in 3 days and sometimes more.So, what could be the best treatment to her [/INST] Hi, There are multiple options for treating depressive disorder, the one which your mother appears to be suffering from now. Before starting treatment I want to be sure of few things. I want to know her Thyroid levels in blood. Has she attained menopause and for how long? If not, Is she having disturbed menstrual cycle? How is her appetite and sleep?Also, we need to get her liver function and blood cells checked. Once we are sure that depression is not due to other physical problems she can be started on antidepressants like Escitalopram, Florentine, sertraline. There are numerous other medicines which will help her. The best could be chosen, once she is examined properly. You can also take her to a Psychotherapist so that few sessions of therapies like cognitive behavior therapy could be taken. She can discuss her problems there, and she would be enlightened with new understandings and also will be taught with some new skills which she might be lacking!! Regular food, sleep, exercise are all the first steps that you can right away start with. She can be definitely helped with so get her to psychiatrist for a detailed evaluation by the earliest. </s>

<s>[INST] Im 16, and I have phimosis. My father tried to pull my foreskin back when I was about 4, but I said NO, because it was too painful. Now, I regret about that.And I dont want to go to the doctors(Im ashamed of my parents)I mean, I have erections, and I have masturbated, but while I was watching porn with my friend, I was commenting penises of actors, and my friend said that he has the same one. Then, i searched Web, and found that I have phimosis.Masturbating every day I am able to pull foreskin more and more. (what is a non-medic way to cure phimosis)Ill keep masturbating more and more, and maybe Ill be able to pull it totally!i want to know, when phimosis is cured, does penis size increases,or stays same? [/INST] Hi, The definitive treatment of fibrosis is circumcision. Masturbation is not the solution for it n later it may lead to loss of libido, premature ejaculation, etc. Just talk with your parent regarding fibrosis (don't feel ashamed as plenty of people suffer from it and leaving it like that may lead to other complication in your life) and visit a urologist for further management .HOPE THIS WILL HELP THANKS N REGARDS Chat Doctor. Com </s>

<s>[INST] I am now post gallbladder removal of about 4 months. The earliest they can get me in is in 2 weeks (go figure). I have been having an extreme issue with food passing through me way too quickly so much that I believe I am becoming malnourished - I am way too skinny and can t seem to gain weight. I only have pain immediately after I eat and once the food passes through me, I feel better. I found dumping syndrome and it fits me to a T. I can t find enough information on the internet to help me with diet - I am fit and eat quite healthy (mostly) and this is affecting my everyday life. I like to try natural remedies - what can I take to slow down digestion AND what can I eat? I found a site that listed fruits that aid digestion, but from reading, I need to stay away even from natural sugars (such as in fruit). I am in fear of landing a teaching job because I constantly need to be near the restroom within 5 minutes (or less) of eating. Thanks! [/INST] Hi. Diarrhea is not a rare complication of after cholecystectomy or better is a common symptom, part of what we call post cholecystectomy syn Chat Doctor. Bile is important in fat digestion so I'd recommend being careful with fatty foods in your diet. As for a better digestion I'd suggest Cholecysmon for a month (two pills after eating two times a day).It's just a replacement therapy and we can discuss again after. </s>

<s>[INST] Hi. Since last week I ve been feeling spasms in my chest followed by a warm rush of blood sensation. I actually went to emergency because of this and was admitted to hospital for a few days with tachycardia. They reduced my heart rate with beta blockers but never addressed theses spasm sensations which are more disturbing to me than the fast pulse. [/INST] Thanks for your question on Chat Doctor. I can understand your situation and problem. Betablockers are known to cause bronchospasm. Beta receptors in bronchi are needed for bronchodilator, Especially beta 2 receptors. So whenever nonselective beta blockers are given, they will block the action of beta 2 mediated bronchodilator and cause bronchospasm. So better to start cardio selective beta blocker (beta 1 selective). It Is having only beta 1 action and no action on beta 2 receptors in bronchi, So no bronchospasm. Beta 1 receptors are present in heart so beta 1 antagonist (cardio selective beta blocker) will have effect only on heart. So consult your cardiologist and change to cardio selective beta blocker. </s>

<s>[INST] My husband and i are dog sitting and the dog bit my husband and broke skin now his fingers are tingling and swollen i soaked his hands in peroxide and cleaned them with alcohol then put neosporin an bandaged him up the dog has not had any of his shots should we be worried [/INST] Hello, Welcome to Chat Doctor, Even if it is a scratch or abrasion or bit of a dog requires proper and adequate treatment. The dog has all the potential to transmit rabies, which is 100% fatal, but it is 100% preventable by timely treatment. For your condition I would suggest you to follow1. Thorough wound wash with soap and water2. Antirabies vaccine on days 0,3,7,14 and 28. If the biting dog is healthy after 10 days you can discontinue last two shots of antirabies vaccine.3. Inj Tetanus, 0.5 ml should be taken.4. The wound may require a course of antibiotics like tab Augmenting.Don't take any risk with this disease. Hope you will follow This advises by consulting your doctor. Thank you. </s>

<s>[INST] Last week I noticed a lump in the back of my leg, just below my knee. I don t know what caused it. It is not bruised. It s approximately the size of a golf ball, firm, and hurts when I press on it. Sometimes my calf and even foot feels tight. I do water aerobics 3 times a week, but I don t recall a sudden pain. I am 53 year old breast cancer survivor, so of course I m wondering how concerned I should be ... [/INST] Hi, Dear , Thanks for the query to My Chat Doctor clinic. I studied your query and understood your concerns. In my opinion-you suffer from-Popliteal cyst or /? Morant Bakers Cyst of the Knee.-Its due to the arthritis of the knee with cystic swelling thought the defect in the Popliteal fascia of the Knee joint capsule.-You need to consult an ER Orthopaedic-Surgeon who would Repair MB cyst or popliteal cyst. Hope this would resolve the issue and would help you to plan treatment. Wellcome for further queries in this regard. Good Night. </s>

<s>[INST] I just finished chemo & radiation for anal cancer. I had a tumor around my anus, stage 2 that was first surgically removed along with hemorroids. within the first month after treatment, I have a soft lump from front of anus towards my vagina. it is very painful to touch. what could it be? [/INST] Hello.... You have got surgery and chemo radiation for your anal cancer...ND as u have lump near UT anal canal may be due to some cause.... as it is painful its more likely to be infectious... Becoz chemo and radiation also lowers the immunity of body... Better to confirm and rule out new malignancy primarily a sonographic scan would be a better option...along with routine blood investigation... That will lead us to a proper diagnosis and treatment </s>

<s>[INST] My nephew is suffer from mental trees . She is student of 2nd year bachelor in pharmacy . Last few days her behaviour is not as normal person. So we decided to treat her to psychiatric. I want your appointment for above issue. When I come to your clinic. Please confirm me. [/INST] Degree understand your concerns went through your details. I suggest you not to worry much. I think the intention of the query is very clear. But there is no substance. Whom do you want to meet? With whom you want to make an appointment? Please be specific with your query, I request. 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] iam 20 male, i do masturbate from 12. My nipples became like womens nipples, i noticed it when i was 13, i thought it will get cured automatically but it hadn changed til now. I feel shame to sit without shirt even in home. I cant wear a shirt or t-shirt without a vest inside.I also wanted to know whether my penis and testicles ard normal, my one testicle is large than other when it is loose, sometimes both testicles are tight and on that time both are equal size.Im uncircumcized, i pulled my peniss foreskin only before 2 weeks, i found my peniss head completely surrounded by yellow particles on the 1st time i pulled the foreskin. After two days i pulled it back, then i found the same yellow particles, but this time it was in liquid form and the quantity was very less. And i hadnt pulled the foreskin completely yet.Please help to get rid of my women nipples, and is my penis and testicles are normal?Iam very much thankful to you. [/INST] Dear serve understand your concerns went through your details. To make your chest tighter and to reduce the size of topples, do chest push-ups 20 times twice a day regularly. Also do other physical exercises and play some games. Don't worry about testicle size and shape. They tend to change every time. Only worry of there is pain or swelling. The yellow particles are dirt. You must clean the inside of the foreskin with mild soap and remove those particles. 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] Hi it is now my 5th day since i had my wisdom tooth extracted (growing in wisdom tooth) lately ive been feeling this itchy hurt. And it was still bleeding this morning . Im not sur if its still bleeding right now coz i just finish eating but then i looked at in the mirror and theres this kinda whitish thing then theres a black thing on top of it not sure but it doesnt hurt really bad but it hurts a little kinda feeling the nerve then to my ear is that normal .. I dont want to go to the sentist again coz its expensive i dont have an insuranceAlso can i now brush my teeth with toothpaste (colgate optic white).? [/INST] Hi, Thanks for asking the query, Pain and swelling are most common after wisdom tooth extraction, and they subside after sometimes, according to your clinical symptoms I suppose that you might have some trauma to the nerve at the time of extraction. I would suggest you to take multivitamin supplements for 15 days. Take lukewarm saline rinses. Take antiseptic mouthwash gargles. Avoid smoking and consumption of hot and spicy food stuffs. If the symptoms persists or worsen then you have to visit to the concerned Dentist and get the checkup done. Hope you find this as helpful, Regards. </s>

<s>[INST] I am a caregiver for my sister and she has been treated for two types of infection after surgery in November. She has had MRSA in the past and the latest culture shows this again. As caregiver I always wear gloves when working with her and she also has home health care. My question is what other precautions should I take when caring for her [/INST] Hello! I have been through your question. Related your concern you should know that a MRSA infection can attack those most vulnerable, older adults and people with weakened immune systems. MRSA can spread easily through cuts and abrasions and skin-to-skin contact, homosexual men have a higher risk of developing MRSA infections and living in crowded or unsanitary conditions. Usually in the hospital, people who are infected with MRSA often are placed in contact precautions as a measure to prevent the spread of MRSA. Visitors and health care workers caring for people in isolation may be required to wear protective garments and must follow strict hand hygiene procedures. Contaminated surfaces and lawn Chat Doctor. What I suggest in your situation is wear gloves, washing carefully the hand after gloves are removed, scrub hands briskly for at least 15 seconds, then </s>

<s>[INST] Hi Doctor, I am unable to breat properly...specially at night..it feels like something is chocking my throat..I even visited emergency...but they advice to gargle...and gave me some antobiotic...but its not helping me completely...in day time its ok but in night its worse,what should I do [/INST] Hi welcome to Chat Doctor... Here your posterior pharynx examination needs to be done ...along with auscultation ... If auscultation reveal rhonchi or crew than digital chest x-ray and spirometry done for further evaluation.... According to cause treatment given.... If chocking is from inflammatory sweller than anti-inflammatory Chat Doctor. ... Avoid excess spicy and excess fried food ... Take care Advise : consult pulmonologist for examination </s>

<s>[INST] I am a 34year old female who normally has a perfect BP reading-I have tested myself several times over the last few days. My BP reading has been 120/100 it hasn t got any higher. Should I get this investigated. I do have a family history of hypertension. [/INST] Hi thanks for asking question in Chat Doctor. You have absolutely normal blood pressure. If you are suspecting genetic tendency for high BP then it might be elevated until this age. You have 34 and have absolutely normal BP. According to few studies it has been shown that with advancing age chances of increasing blood pressure is high. Today patients are suffering from high blood pressure because of bad lifestyle habits, sedentary lifestyle, smoking, fatty diet etc. So if you have family history of hypertension regularly every three monthly check your blood pressure and maintain healthy lifestyle with healthy diet. I hope my suggestion will help you. </s>

<s>[INST] I have bad coughing and wheezing for 4 weeks now. I ve been to the dr. He gave me a zpak and cough med. The 2nd time I went to his office he gave me steroids meds because my white blood cells are extremely low so he thinks my symptoms are due to an allergic reaction. This is week 4 and I m still the same. Now I have a sharp stabbing pain on my left rib under my breast. I don t know what else to do. [/INST] Thanks for your question on Chat Doctor. In my opinion you should get done chest x-ray and Pulmonary Function Test(PFT). Chest x-ray is needed to rule out lung infection as this can cause similar symptoms like chest pain and wheezing.PFT is needed to rule out bronchitis as this will also cause wheezing and chest pain. So better to consult pulmonologist first and get done chest x-ray and PFT. Steroids should be given in appropriate indication. And low count is not at all an indication. So avoid these Chat Doctor. </s>

<s>[INST] i am 25 year old guy with the problem of hair loss. I consulted with dermatologist he first pescribe "morr-f 5%, then and follihair tablet, then minokem 5% then minikem 2%, then alpecin lotion and keratop tablet" but still its not under control. Now he pescribe hair 4 u 10% and keratop. what should i do? [/INST] Hello, you should ask your diagnosis, the treatments given suggest an Chat Doctor. Now, for this condition, the therapy comprises 5% minoxidil (of whatever brand) which works slowly, max effect seen around 6 months, and you need to continue it usage forever to maintain the new hair growth, along with tab Finasteride 1 mg daily for 12 months. So, u confirm your diagnosis and stick to the treatment. ThanksTake care </s>

<s>[INST] Hi, I was seen recently by Mr John McMahon at the Alfred Hospital and I have a cyst growing between two vertebra and into my spinal column. I am on a waiting list for surgery but I would like to know a ball park figure for the cost if I was a private patient please. [/INST] Hi, Thank you for posting your query. I have noted your complaint and note that you are on waiting list for surgery. The exact cost of surgery would depend on the type of surgery and its details. In India, the cost of a similar surgery would be about Rs 2,50,000/ (about 4000 USD). I know it is about 5-10 times more expensive in the USA. I hope my answer helps. Please get back if you have any follow-up queries or if you require any additional information. Wishing you good health, Chat Doctor. Ly/ </s>

<s>[INST] hi,i am 26 years old male, i weigh about 75 kgs. I had a fungal infection in my groin. After taking some medicines the doctor prescribed, the infection seems to have healed, but the dark scars remain, how do i get rid of these scars? Also how do i avoid recurring infection? [/INST] Hello dear, Thank you for your contact to Chat Doctor. I read and understand your concern. I am Chat Doctor answering your concern. The scar of fungal infections are temporary. It will go on after some times. Recurring fungal infection has two important underlying because one is HIV second is diabetes. As per your age I think you must test your self for the HIV is the most common cause of fungal infections. But it can also occur in other condition like frequent sweating. So by avoiding this we can also avoid fungal infections. Take the complete treatment for the fungal infections. With proper precautions once cured these infections will never reappear with proper precaution. Please maintain good hygiene as this is the key in treating all the infections. Please wear cotton undergarments as this can help cure the infections. I will be happy to answer your further concern on bit.ly/ Chat Doctor. Thank you, ChatDoctorInfectious diseases specialist, ChatDoctor. </s>

<s>[INST] Hi I am 51 female ,perimenopausal,for the last 18 months I have suffered with a yellow coated tongue in the morning and it is getting a lot worse.I feel awful in the mornings any way and look generaly unwell.I have a healthy diet.I am seeing a gynocologist for cyst on my ovaries and my uterus had a thicker lining than normal.I have a lot of wind and bloating and pains in my abdomen-I am a bit of a mess. Can you help [/INST] Hello:)Welcome to Chat Doctor. A yellow tongue indicates accumulation of bacteria. Your hormonal irregularity can add to this. These bacteria then release certain chemical to make the tongue yellow in color. Have adequate water 3 liters per day. Reduce consumption of caffeinated beverages. Maintain oral hygiene and floss daily. Use a mild mouth wash thrice a week. Cleanse your tongue regularly using a tongue blade. Quit any tobacco and alcoholic habits. Regards. </s>

<s>[INST] I have a uti, I get them all the time and the doctors would prescribe me antibiotics and they would come right back. Ive tried everything. The only thing is now I dont have insurance and cant afford to see a doctor right now. Is their anything I can buy to cure it? Home remedies maybe? [/INST] **1. Ideally urine sample should be sent for culture- sensitivity and colony count, before initiating treatment. As soon as the result of sensitivity test is available, treatment is started [or changed, if already started] according to maximum sensitivity.2. Since you don't have health insurance, even then predisposing factors to infection like: obstruction, calculus, diabetes should be properly identified and managed/treated [for which opinion of urologist is necessary since he may distinguish lower tract infection from upper urinary tract infection]3. Take plenty of water and fluids. Avoid: hot/spicy foods, salt, garlic,mustard oil, citrus fruits, alcohol,excess physical exertion. Take: Jagger with cold water, coconut water, amla, dates, musk melon, watermelon. A few teaspoons of baking soda diluted in cup of water, followed by at least 2 cups of water is effective. You may ask for prescription medicines like: tab Calgary, tab/syrup cyst one, Chandon Assam, usher Assam. </s>

<s>[INST] my 24 month old grandson recently had an ear infection Friday he went for his follow-up and the Dr. said infection gone but he have water in his ear how do I remove the water. If the water remains in his ear will it eventually cause another infection? [/INST] Hello. I just read through your question. This is not uncommon. Sometimes fluid can remain in the ear after the infection is gone, and sometimes this can lead to another infection. In most cases, though, fluid in the ears resolves on its own. You should follow up with your doctor in about one month to confirm this. If the fluid is still there, your doctor may want your grandson to be seen by an ENT. Until then, however, there is nothing to do. </s>

<s>[INST] Hi, I am 28/M. I am using Levolin inhaler for the past 1 year. Although my physician didnt prescribed me this. 2-3 years ago my physician gave me Combitide 250 inhaler. After this I used to take Levolin inhaler. I generally never have any strong problems during working times. My problem only starts in Nights when I go to bed to sleep. Not only that, I dont take Levolin daily. I only take Levolin when I feel breathlessness. Is it dangerous to continue using Levolin? [/INST] Hello. Welcome to Chat Doctor. Levolin has side effects such as tremors, palpitation, etc. I think you are having asthma. If you need to use leveling more than twice a week, it indicates that your asthma is not properly controlled and your bronchial tubes are staying inflamed, which will not be relieved by leveling only, you will need to use controller inhaler (containing corticosteroid) daily. One more suggestion is that as you are having more problems after going to bed in night, I would suggest you to consult an allergist & get allergy tests done. Possibility is that you might be having allergic to house dust mites & appropriate measures can be suggested based on allergy testing results. Hope this was helpful to you. Wish you best of the health. Regards. </s>

<s>[INST] Have had Gallbladder out in 1976. #weeks ago was in Hosp for x5 days with pancreatitis,due to stone caught in Pan duct. Acute pain I had was that I passed stone again. I have lost 15lbs and now left with mid to right sided pain all the time. Just near Xyphoid process MD says all labs are normal.I am trying to eat small low fat ,no sugar meals x5 day. I have never been sick before ,i know I am a little over weight. I was on no meds before this.I am active and always on the go. 64 yr female now retired. What should I do as I have a GI ,MD appt but not until Nov 4th. Thanks L. [/INST] Hi.noted cholecystectomy several years ago and recent history of pancreatitis presenting as abdominal pain. The location of pain from an inflammation/infection in your pancreas is usually located in the upper portion of your abdomen, epigastric with radiation to left or right side or back area. This is usually accompanied by elevated pancreatic enzymes. It is best if you consult with a doctor, preferably a gastroenterologist or do a follow-up with your surgeon, for physical examination and clinical evaluation. Diagnostics (such as ERCP?MRCP, ultrasound, liver function testing, bilirubin, etc.) and management (medical and/or surgical if indications are found) will be directed accordingly. Hope this helps. Good day!!~ Chat Doctor. </s>

<s>[INST] good evening I have been feeling on my left side of my brain it feels like cold water is running on my head as well as I feel like my oxygen level has lowered a lot the pain you get in your diaphragm when having hick ups except when it occurs I don t have hic ups I am 27 weigh 135 and 5 5 [/INST] Hello! Welcome on Chat Doctor! Regarding your symptoms, they do not seem to be indicative of any serious medical condition. Psychological stress could be the reason of all these troubles. Nevertheless, I would recommend performing a brain MRI (considering the fact that these feelings are always on the left side of your head) and some other blood lab tests (complete blood count for anemia, thyroid hormone levels for thyroid dysfunction and inflammation tests). Hope to have been helpful! Wishing good health, Chat Doctor. </s>

<s>[INST] hi. im going to kenya next month and have to have immunisations including yelow fever, hep a and b, malaria tablets and was wondering if there is a certain amount of time we will have to wait after having these injections before i get pregnant as i don t want to increase risks to baby [/INST] Hello, After such immunization schedules, it is better to wait for three months before trying to conceive. Usually, a period of two weeks to one month is suggested after live vaccine injections. Since these are only prophylactic procedures, there is no specific restriction, but, as a safety precaution, you can use temporary contraception for 6-8 weeks at least. Please use prenatal vitamins right from now on. You can also see a specialist once you settle down for further plans. When immunization is advised for Rubella in TORCH infections, pregnancy is strictly avoided for 3 months after vaccination. Hope this helps. </s>

<s>[INST] Hi, I am a 25 year old female. I have been experiencing episodes of dizziness, sharp headaches, blurry vision, and sometime i feel spaced out like a robot. I sometime feel like im walking slanted. It comes and goes. One minute this is happening the next I have my energy back. This has been happening for two weeks now. What could this be? [/INST] Hi, Thank you for posting your query. The possibilities in your case includes a peripheral vertigo and vertiginous epilepsy. You should consult a neurologist for detailed evaluation, including MRI brain and EEG. As of now, there is no need to worry. Both the conditions mentioned above responds well to medical treatment. Please get back if you require any additional information. Best wishes, Chat Doctor. Ly/ </s>

<s>[INST] SIr I have been experiencing some pain in the right side of my belly for the last one week my blood report shows high SGOT ?can you please advise what should I do my general practicioner has prescribed some medicines and asked me to wait for another 5 days its is already a week now that I am suffering ? [/INST] Hi. Thanks for posting query at Chat Doctor. Usually ALT or AST values higher than "two times the upper normal limit", is considered abnormal (in some countries, ALT or AST values of more than 100 are considered abnormal). Value of AST or ALT greater than 85 or above maybe investigated further. Viral hepatitis (HAD, HBV, HCV) are common cause of elevated liver enzymes. Typhoid fever may also affect liver and cause high liver enzymes. Advice :- abstinence from "Alcohol" - LOW fat diet should be followed, AVOID junk food and beverages-decreased oil consumption (oily food)- NO red meat-green vegetables should be ingested daily-use lemon juice (lemonade) once in a day-reduce weight if overweight/obese-"recheck liver enzymes after 6 to 8 weeks" and/or ultrasound. Any further questions are welcomed. Hope to answer your concern. Wish you good health. Regards, Chat Doctor. </s>

<s>[INST] my son is a healthy 11 year old male. he had the flu and bronchitis the first week of March and was given numerous meds including two types of antiobiotics. On sunday night after going to the fair, eating cotton candy, mcdonalds and a slice of pizza he went to bed and shortly woke up with a headache, dizziness and vomited. after that he has been having dry heaves for hours at a time only seconds apart. He only tends to stop when he is very afraid of something. he complains of lower stomach pains and so far all of his organs are healthy and functioning well. however he does has air pockets outside his intestines. [/INST] Respected user, HiT hanks for using Chat Doctor.come have evaluated your query thoroughly.* Actually your son is having respiratory along with gastrointestinal infection.* Suggestions for better recovery - Allow plenty of liquids in sessions.- Soft, light diet at intervals.- Avoid all oily, spicy, non veg, junk foods, excess caloric, dairy items chocolates, candies, hot beverages etc.- No prolong fasting, over eating.- Avoid exposure to excess cold.- Intake of decongestants, antibiotics, bronchodilators or other molecules have to be decided by the clinical examination. Hope this clears your query. Welcome for further assistance. Regards. </s>

<s>[INST] I just had a hysteroscopy and polypectomy performed under general anesthesia. I had the surgery at 8:30am, left the hospital a little groggy but otherwise fine at 12pm. However I now Have numbness and tingling in my hands and feet. Is this normal after general anesthesia or should I be concerned? [/INST] Hi, Welcome to Chat Doctor .com I am Chat Doctor. Mariano Into Bruno Mascaras. I have gone through your query with diligence and would like you to know that I am here to help you. Question : However I now Have numbness and tingling in my hands and feet. Is this normal after general anesthesia, or should I be concerned? Answer : This is not normal. You have to immediately go to ER and report about this Hope you found the answer helpful. If you need any clarification / have doubts / have additional questions / have follow-up questions, then please do not hesitate in asking again. I will be happy to answer your questions. In the future, for continuity of care, I encourage you to contact me directly in Chat Doctor at http://bit.ly/ask </s>

<s>[INST] Hi, recent blood test showed rare tear drop cells, rare ovalocytes, slight microcytosis, slight macrocytes, I went in to the ER with a possible ruptured ovarian cyst last Thursday, US showed a 3.2cm complex adnexal reticular hypoechoic mass and free fluid, possibly endometrioma. My Dr wants to sit and wait, I want to get this out. Hysterectomy 5 years ago from endo, (Adenomyosis) Thoughts?, feeling very tired and in pain. Loss of bladder control, groin pain and back pain for 2 months prior to ER visit, affecting my running (half marathon runner) Groin pain for 1 year prior to ER visit. [/INST] Hi, dairy have gone through your question. I can understand your concern. You may have chocolate cyst(endometriosis of ovary). You should go for surgery and removal of that. Your blood picture suggests mild biomorphic anemia. It means you may have mild iron and vitamin B 12 deficiencies. Check your Iron and it b12 level and take treatment accordingly. Hope I have answered your question, if you have any doubts then contact me at bit.ly/ Chat Doctor. Thanks for using Chat Doctor. Wish you a very good health. </s>

<s>[INST] Hello,I took my six year old to the dentist today and Dr said that one of her molar were she has a crown is infected and said that it needs to be removed and then have a spacer in. I ask if my daughter would need to be on antibiotics first and she said no. Should I get a second opinion? [/INST] Hello, I often prescribe an antibiotic when I extract a tooth, but not always. If the extraction was complicated or the patients medical history raises some concern about healing ability, I will prescribe an antibiotic. I often prescribed an antibiotic prior to removal to control the spread of an active infection or for a very symptomatic tooth. Pain medication and anti-inflammatory medication may be adequate. Should of painful situation arise 3 to 4 days after an extraction, I would be concerned about a Chat Doctor. I would suggest a second opinion if your concern is whether the tooth should be extracted. There may be an option to save the tooth. You could ask the current dentist if there is any other option for this tooth. Thank you for your inquiry. I hope my answer is helpful to you. I would be glad to provide additional answers if you provide additional details or have more questions. </s>

<s>[INST] I have had a persistent yeast infection for about six months. Have tried longer courses of diflucan, canesten creams and pessaries to no avail. I take probiotics, eat live yoghurt, and follow all the usual intructions to help the problem. Have had several swabs come back positive for yeast plus have had all the other tests for underlying problems but there is nothing. Am not on the pill and dont have a partner. Any help would be greatly appreciated as it is really getting me down. [/INST] Hi, your history suggest that you have got recurrent candidiasis infection. If I were your treating doctor, then I would suggest1) To undergo a course of intravenous antifungal treatment, which you can discuss with your physician.2) To check your blood profile to rule out Diabetes (i.e. check your blood glucose levels) and other conditions that may reduce your immune level, that can be elaborately discussed with your physician.3) To maintain adequate hygiene, and keep the infected regions free from moist(dusting powder may help). Hope I have answered your question. If you have any further questions I will be happy to help </s>

<s>[INST] I have dry itchy patches on my legs that have small bumps that have clear fluid when scratched. After scratching they become bloody sores. I used a steroid cream and it made it inflamed and spread. Only thing that seems to ease the itching and pain is athetes foot cream but it makes my skin so dry then the itching starts and then the cycle repeats [/INST] Thanks for posting your query to Chat Doctor. As I understand it could be an infection. First I suggest you to go for microscopic examination of fluid and skin scrapping from itchy area. It will guide us about causative agent of disease, either it could be fungal or bacterial or mixed. Avoid steroid containing cream as it can enhance fungal infection. After final diagnosis I will suggest you correct management. Hope it will help you. </s>

<s>[INST] 2 weeks ago i have difficulty in passing urine so i concern doctor who advised me for my kidneys ultrasound, my report is:BOTH KIDNEYS:normal in size,shape and texture corticomedullary distinction intact 2-3 small calculi seen in calyces measuring 0.3 cm right kidney show fullness of pelvicalyces left kidney show mild fullness of calyces no perinephric fluid collection seen URINARY BLADDER:mild thick walled no calculus or growth seen in lumen at scan time.please explain me my disease and also please tell me the good doctor in karachi for kidney problems. [/INST] Hi, dairy have gone through your question. I can understand your concern. Your ultrasound abdomen reports suggest that you have 2-3 very small kidney stones. No, any other problems in kidney, ureter or bladder. You should Chat Doctor. If you don't have any symptoms then no treatment is required right now. Because stones are very small. If you have pain then diclofenac sodium is used for pain relief. Follow-up ultrasound is required. Then you should plan 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] My Grand daughter has a high temperature of 39.4 degrees. She is cutting her eye teeth at the moment as well. Could this cause her high temperature. Her mum took her to the hospital last night and they had to give her a suppository as she would not drink anything, to stop the temp. There is no throat infection and a urine sample has been taken, but will not know for a few days? Thanks [/INST] Hi... Thank you for consulting in Chat Doctor. Fever of few days without any localizing signs could as well a viral illness. Usually rather than fever, what is more important is the activity of the child, in between 2 fever episodes on the same day. If the kid is active and playing around when there is no fever, it is probably viral illness and it doesn't require antibiotics at all. Once viral fever comes it will there for 4-7 days. So do not worry about duration if the kid is active. Paracetamol can be given in the dose of 15 mg/kg/dose (maximum ceiling dose of 500 mg) every 4-6th hourly that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol. 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. </s>

<s>[INST] Hi, Is it safe to take I-pill (contraceptive pill) during periods. I had unsafe sex(without condom) on 1st day of period and today is 2nd day. If I take I-pill, will any complication arrive in future to conceive. I don t want any complication in future due to emergency contraceptive pill. Please suggest. [/INST] Hi there, After going through your question, I am of the opinion that:1) There is no need to take an pill during periods.2) Having sexual intercourse during periods does not lead to pregnancy and since I pill is used to prevent pregnancy, no point in taking it.3) I pill does not have any effect on future fertility and can be occasionally used in emergencies.4) However, in my opinion, it is always better to have protected intercourse if you do not want pregnancy, and also it helps in preventing other sexually transmitted diseases. Hope this was helpful. Chat Doctor. </s>

<s>[INST] Hi i am 27 yrs female.My bothovaries are enlarge in size but have normal shape,outline and echogenicity.There are multiple small (less than 5mm) cysts at peripheral parts of both ovaries.No calcification is seen in ovary. Right ovary measures 30.0x22.5x40.0mms(vol:-14.2cc) and left ovary measures 32.8x15.3x35.2mms(vol:-9.2cc).I do not have my periods regularly without oral pills.Can i have baby after marriage?please help........ [/INST] Hi, You are having POD (Polycystic ovary disease). Let me start by saying you will definitely have as many pregnancies as you want. But will need some effort from your side. Typical PRO has such peripheral arrangements & volume of ovaries will be>10 cc & periods irregular are in right age for pregnancy. Try to reduce your weight, Height in CMS -100= weight in reduce fat around the midsegment of body. Even if you are not overweight, have regular exercise for midsegment of body, controlled low calories diet, avoid junk food. No fasting please. This itself without any medications will normalize your hormones, periods & ovulation. Now your eggs are not rupturing on their own, they are seen as multiple cysts on scan, so they don't meet sperms, so no pregnancy. Only if your follicles rupture your periods will be regular. If you get pregnant with abnormal hormones, you stand a chance of early abortions too. Just get your Thyroid profile & Serum Prolactin level checked in early morning, empty stomach. They, too, may affect ovulation. All these are correctable. Not to worry about the best Chat Doctor. </s>

<s>[INST] Hi, today I witnessed my elderly father(80 years old) suddenly find it difficult to walk. He could not seem to move his legs . My mother had to help him sit in his wheelchair and put him to bed. His hands were twitching constantly and he was unable to hold anything. He has been unable to chew or swallow his food however he did drink when a cup was held to his lips. My father has experienced bouts of this over the last 3 months,the last one being 9 days ago. My Mother has told me that usually after a few hours my Fathers motor skills and speech become normal. However todays attack was longer than normal. He has suffered with severe ulcers on both his legs over the last 4 years and has been hospitabilised a number of times with bad infections. My Mother has consulted the GP and they have refered my Father to a neurologist however we are still waiting to see the consultant. Can you give us some understanding of what could be wrong with my Father please [/INST] Hi, I am Chat Doctor. I have read your message. I think I can help you. The symptoms of the query are quite suggestive of a stroke. The sudden onset of the symptoms, the motor weakness, the swallowing and speaking difficulty, the shaking of hands. All symptoms are suggestive of the diagnosis of stroke. The fact that he had been having similar episodes over the last 3 months is suggestive of mini strokes that we call TIA medically. These are usually warning signs of an impending stroke. I am unaware from the query about the duration of the symptoms. Within 4 to 8 hours onset should be treated urgently and should be visiting an EMR as soon as possible. He will need urgent treatment. If it is more than that, he needs to meet a neurologist who will probably perform a CAT scan of the brain with or without the angiogram (depending on the protocol of the hospital). As per the report of the CAT scan, medicines may be initiated. I think a low dose statin and antiplatelet should help. I would suggest a scan prior to the initiation of the medicines because the closest differential is a possible cerebral hemorrhage (less likely in view of the mini strokes) where these medicines are not to be given. Meanwhile, I think you should start him on physiotherapy for the motor weakness. Another chance I want to consider here is possible diabetes and hypoglycemia attacks. If the GP has thought about this as a possibility and tested sugars, there is probably nothing to worry about. Otherwise, hypoglycemia in a diabetic patient would explain the brief episodes. And a hypoglycemia can also explain the prolonged symptoms. In such a case, sugars need to be well monitored. The third possibility I need to consider is a vasculitis. This is a common cause of stroke, but usually is thought of in young patients. The last 2 causes I have considered in the view of preexisting foot ulcers which cannot be explained by TIA or current stroke as the ulcers predate the stroke. I think you need to get the scan and meet up with a neurologist. Unfortunately, as explained, I cannot suggest medications without the scan. I have tried to make it as simple as possible. Please feel free to contact me for any further clarification. Best of luck, </s>

<s>[INST] Hi I am a 27 years old female .. I am married since 1.5 years .. I was using protections like condoms .. I didnt take any medicine .. But before almost 2 months we were deciding to make a baby .. My period was supposed to come on september,20th .. But it has been 3 weeks, the period signs are clear like my breast got bigger and i have a stomachache but there is no period .. After 5 days of the due date i tried the pregnenacy test at home (negative) after 2 weeks from the due date i did a blood test (negative) i went to a doctor and she told me to take Primolut -Nor but i didnt take it cuz i am not sure yet .. So is there is a possibility of being pregnant ! Should I wait ! Or do the test again .. Please help [/INST] Hi dear, I have gone through your question and understand your concerns. Delayed periods can be due to pregnancy, stress or hormonal disturbances like hypothyroidism, hyperprolactemia or polycystic ovarian disease. I will suggest you to repeat the urine pregnancy test, if still negative, then you should get your hormonal profile and ultrasound done to confirm the diagnosis and get appropriate treatment. Hope you found the answer helpful. Wishing you good health. Chat Doctor. </s>

<s>[INST] pI started out with what I thought was a canker soar but after putting powdered elm on it realized their was another inside the bottom of my teeth (the floor of my inside teeth...my gums are red and see a few white patches on them Would this be oral cancer? I have been using preroxide to kill what is in there?? [/INST] No this would not be an oral cancer but yes it can be a pre-cancerous lesion though. If you have any habit of tobacco chewing or smoking I would suggest you to discontinue that if not and still you have such a patch it could be due to fungal infection in which case you will be able to scrape that patch, and it would appear more like curd. Also, please get rid of using peroxide as it would only exaggerate the problem if used without knowing the cause. For further investigations I would suggest you to get a biopsy and clarify what it is and only then take whatever medication is needed. </s>

<s>[INST] I have burning pain in my lower right abdominal region, sometimes it shoots up to me belly button or hip bone and its mainly up to the belly button and on the right side in the bikini line area. I had the burning sensation pain for 4 almost 5 days now. Could this be my appendix? I have no fever or nausea or anything just uncomfortable burning sensation pain all around this area. [/INST] Hellos you mentioned that there is burning sensation pain in right lower abdominal area, radiating to belly button. Appendix is ruled out in my opinion because in appendicular pain there is excruciating pain at typical point known as McBirney point and not radiate to belly button. Usually in appendicitis there are nausea, fever, vomiting. So this type of pain in your case may be due to these possibilities, This includes.1 Right renal calculus as pain is also radiating to hip bone, so this is a characteristic feature of renal calculus. Diagnosis can be confirmed by ultrasound of both kidney. However, pain anywhere in urinary tract system causes pain in this area. 2 Ovarian cyst or salpingitis is the another most common cause of this type of pain. Get in an ultrasound of both ovaries .3 Amoebic colitis is another cause of such pain, so please get in blood as stool examination to rule out amoebic colitis. In this case physical examination also play an important role. Hip joint pain is also once such cause, besides this there are so many other causes, so in my opinion deal as I mentioned above and consult a physician and get his opinion as physical examination will find the exact disease. Good luck. </s>

<s>[INST] My father is 65 years old. He has been operated for staghorn stone (55mm) on 11 july. But his tlc and fever hasnot decreased and it goes up to 23000. On 2nd september Dr operated him and removed his kidney due to infection. After that his tlc come down to 11000. During this period has been injected high dose of sudopen. But again it incresing from last 3 days and now it is 13000.. what to do.. pls suggest. [/INST] HelloThanks for query. Your father has undergone surgery for stag-horn calculus and subsequently developed infection which was manifested by high grade fever and raised WBC count which were not controlled even by taking higher antibiotics for long period hence surgeon has to remove his Kidney (Neurectomy). Please get his routine urine test and urine culture done to find out the organisms causing this infection and antibiotics to which they are sensitive to so that he can be given appropriate antibiotics to control his infection and WBC count to come down to normal. Since the focus of infection (Infected Kidney)has been eliminated from his body and his WBC count is showing downward trend there is nothing to be worried about He will most likely be normal within 2 weeks. Chat Doctor. </s>

<s>[INST] HI Doc... I am geeta from India 31 yrs old.... married and trying to conceive but no success... we generally have sex on weekends as we both lives in a different city as of now..and meet on weekends.. so this time... my periods started on 13th Sep and ends after 2 days which is 14th by 15th i bleed but lil bit... we had sex on 15th night... are there any chances that i may conceive? [/INST] Hello, Unprotected sex just after period over is very much safe and there is no chance of pregnancy at all. To maximize chance of pregnancy, you have to unprotected sex on ovulation day (14 day prior to next due date) or fertile days (12th-18th day of each 28-30 days cycle). You can use ovulation prediction kit in the mid-cycle. Take balanced diet with Vitamin-E & folic acid supplements for 3 months, avoid mental stress and take sound sleep. Good luck. </s>

<s>[INST] BADLY SWOLLEN LEG AND FOOT WITH A LARGE RED RASH WITH BUMPS ACCOMPANING THE RASH. WHAT IS THIS . NO PAIN, SLIGHTLY ITCHY TO TOUCH. MANY YEARS AGO I TORE UP SOME KNEE PARTS WHEN I CHASED A FOOTBALL . THE RECOVERY LEFT SOME CIRCULATION PROBLEMS BELOW THE KNEE. I AM RECOVERING SLOWLY FROM A RIGHT SIDE STROKE INCURRED DURING A HIP REPAIR LAST JUNE 15TH 2012. ANY IDEA WHAT THIS IS OR WHAT I SHOULD DO.? [/INST] Hi, Thanks for writing to us. The complaints of swelling, itchy red rashes over legs are related to your circulation problem. Poor circulation leads to stasis of blood leading to sucChatDoctorplaints. This is known as stasis eczema. Use of compression bandage, application of steroid cream and leg elevation would help you. Also consult a vascular surgeon regarding your circulation problem. Hope that helped. Take care </s>

<s>[INST] I have ED. I have tried TRT, gel and injections. My last T was 1,600 so my endo MD said to stop and put me on clomid 25mg x 5 days off 2 and repeat for 6 weeks. Clomid was prescribed because of my desire to have children. However, my fiance will not marry me unless I can penetrate her. I want to try Trimix [/INST] Hi, Thanks for posting in Chat Doctor. I understand your concern. Trim ix is an injectable three- Chat Doctor. Since most of the time, the cause for erectile dysfunction is psychological in nature, you can try the following before switching on to injection. 1. Practice pause and squeeze technique regularly. 2. Do pelvic floor strengthening exercises. 3. Consume diet containing papaya, milk, almonds, saffron, honey and figs regularly. 4. Take Tablet. Tadalafil 30 minutes before intercourse, when necessary. 5. Practice meditation regularly to keep your mind calm and decrease anxiety. Gradually, you should be able to sustain proper erection and perform well with improved confidence. Hope the information provided helps. All the best. </s>

<s>[INST] hey i am 38 years old. my tubes are blocked and i mean both, i dont want surgery to be done to me. I am 250 pounds and i am wondering if the weight has anything to do with my tubes being closed. i just had a baby 2009, and want to have another one but my doctor keeps telling my i cant unless i take a surgery p.s i know its too much information but i really could use your helpthanx [/INST] Hello, Thanks for your query. There is no relation between tubal block and obesity. Tubal blockage could be due to adhesions because of pelvic inflammatory disease or previous surgeries. For RECANALIZATION, you should undergo surgery. Laparoscopic recanalization could be risky because of your weight. All the best. Hope you get pregnant fast. I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow-ups. Wish you good health. Chat Doctor. </s>

<s>[INST] Hello Dr, I M From India, i had one question my Elder Sis 33 Years Old yesterday she took one Tab 10mg Rexipra contains Drug escitalopram but she is feeling too much sleepy even since last night she wake up in morning for few minutes again she slept till now, Pls suggest. [/INST] Hi, Based on the history given your sister seems to be suffering from the side effects of Extra. Extra (Escitalopram) is a selective serotonin reuptake inhibitor (SSRI) commonly prescribed to treat depression and anxiety disorders such as anxiety, panic attacks, and obsessive-compulsive disorder. Its common side effects include dizziness, Chat Doctor. I advise you to take her to an emergency room for further evaluation and treatment. Hope I have answered your query. Let me know if I can assist you further. Take care </s>

<s>[INST] I fell a few days ago and it was light, nothing serious or hurting. But recently, I started to have pain on my right butt, right side, lower right back and leg. It kind of feels like straining and aching. I am okay but it usually starts hurting after I lay down for awhile and then get up. It hurts and I often feel breathless or teary, trying to get up. I am only 15 and had ACL surgery on my left knee about eight months ago. I am 5 3 and about 270 pounds. I hope this is enough info for you to answer. [/INST] Seems blunt trauma that may go easily and pain will go easily. If not take 1 SOS broken adult. You may use turmeric powder in warm milk or water 1/2 tsp once or twice daily. Its natural anti-inflammatory. If doesn't stop, may be nerve is compressed. You have to take lumbar support. Don't bend. Don't lift heavy wt. As the trauma subsides (except that inter vertebral disc spaces should not have reduced), pain will go. Otherwise, physiotherapy and Yoga postures will correct you. But not during pain. Hope it helps you. </s>

<s>[INST] 13 yr old who is sffering from kidney failure [/INST] Hifirst of all...what's your question.?? Considering that your question is regarding the options available for a 13 yrs old with renal failure...now, by kidney failure...I would assume that the patient is on dialysis....if so, then there are two options.....either to be on lifelong hemodialysis or peritoneal dialysis and the other option is to get a kidney transplant, which can be procured from either a near family member (e.g. mother, father, brother, sister) of from a brain-dead kidney donor(known as cadaver donor). Kindly consult your nephrologist for minute details of each of the modalities.... </s>

<s>[INST] I have been prescribed dioxin for my CHF. I have been on it for a couple of years. For the last three four months I have felt very poor - pressure on my chest, hard to breathe at time and feeling very very poorly. Could my dioxin be a possible cause? [/INST] Hello, I think all your symptoms are related to possible aggravation of CHF, and not related to digoxin use. You should get further re-checked your cardiovascular system to rule out the possible aggravation of the disease. You might require some changes in your treatment plan. Discuss this further with your caring doctor. Hope I have answered your query. Let me know if I can assist you further. Take care Chat Doctor. </s>

<s>[INST] yes i am a 30 year old male who was diganosied with a ventral hernia i have noticed that the hernia is getting larger and my abdomen is getting more painful pleas inform to what i can do that might help take away some of the pain in my abdomen it is almost to the point of being unbarable [/INST] Hi ! Good afternoon. I am Chat Doctor answering your query. With the history of your hernia getting bigger and the pain becoming unbearable, I would advise you to report at an ER of the nearest hospital instead of trying any medications to rule out chances of obstruction/strangulation of the hernia which might prove to be quite detrimental for your health. 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] I am a 31 yr old male who has been excessively sweating at night in my sleep. I have sleep apnea, but I have not been using my c-pap machine and recently had an abnormal EKG and have to undergo more testing on that. Could this all be related and what could be causing it? [/INST] The answer to your question, if I have, it right is that the symptoms that you report may be related to sleep apnea. With this problem, you are working very hard all night long resulting in fractured and non-restful sleep. The physical work and difficulty breathing may produce a variety of health problems. Proper treatment is essential as is losing the weight that is so often at the root of the problem. If your breathing apparatus is uncomfortable your physician or sleep provider can help find a setup that will work for you. </s>

<s>[INST] hi I have had a stitch like feeling on my left side of stomach for a week...... i am a bit concerned of what it could be..... its not painful just mild stitch feeling..... its constantly there..... sometimes more obviously there than other times.... but always there...should i go get it checked out.....lower back slightly tender.... not sore just tender. [/INST] Hi welcome to Chat Doctor forum. Thanks for calling, Chat Doctor. Forum. You had a stitch like feeling on the left side of stomach, lower back, slightly tender. It appears to be the small stone in the urinary tract, probably at the end of writer so causing pain in the back. Other causes are hernia of a small portion of the gut or my sentry. You may need to have M.R.I. for confirmation. I suggest you to consult a surgeon for diagnosis and treatment. And to avoid strangulation of hernia. Wishing for a quick and complete recovery. Best regards. </s>

<s>[INST] I had a medial PKR 8 years ago. The xrays show it is still intact and not worn. My leg hurts below the implant and I have pain on the medial side of my knee. I m not sure what this pain can be from. Do xrays detect everything? I ve done lots of backpacking so the PKR held up well. I have lots of pain under the knee cap and on the lateral side of the leg. I can walk for an hour then have to stop due to pain. Sunrise views show both kneecaps are touching the femur and are off center. I believe it is time for a TKR. Are there reasons for a TKR that aren t visible? The xrays don t show it is bone to bone. A doctor says it s time for a revision and my knee really does hurts and limits my activities. I m 62 not fat. [/INST] Dear Patient, Welcome, and thanks for sharing your concern I went through your query, and I feel, you are aware that medial side pain along the joint line is very common with degenerative arthritis, and thus osteoarthritis cannot be ruled out. The x-ray in such cases may not give the whole picture, but is quite good at showing the changes in the joint that may occur as a result of osteoarthritis. So get yourself an x-ray done at the earliest. I hope my advice would have been useful, in decision-making regarding your treatment, still if you have any clarifications or doubts feel free to contact back. Thanks </s>

<s>[INST] For the past month or more i have had a smallish whitish lump on my upper gum above tooth . I have been to dentist and they have done full x-ray of mouth and he couldn t find out what it was and it wasn t an abscess and I have been to my doctor and she didn t know what it was. My dentist is referring me to a specialist in hospital but said i could be waiting 3 to 4 months. What could this be? [/INST] Hi, Thanks for asking the query, Lump in the mouth can be because of several reasons, It can be because of abscess in the arising from the infected tooth, either it can be a gingival abscess due to accumulation of bacterial plague and calculus deep in the gum pockets, can be due to authors ulceration, can be due to irritation due to trauma or smoking and tobacco chewing. I would advise you to visit to Dentist get checkup done. Take an x-ray. Get complete mouth scaling and polishing done . Maintain a good oral hygiene. Hope this helps out . Regards... </s>

<s>[INST] I had papillary cancer in the right thyroid. I ended up with a total thyroidectomy . I also had I-131 iodine treatment. This was in 2010. About 8 months ago I developed Sialolithiasis on the left side. Was treated with antibiotics and was taught how to massage parotid gland which has helped. Now I have developed a knot just below my submandibular gland on the right side. I was told it was a drooping of the submandibular gland due to my age which is 59. I was told this had nothing to do with my cancer or the removal of the thyroid. I have been looking up a forum to this nature which suggest otherwise. Multiple people have commented and their situation is like mine or very similar. Has there been any studies that might be a link between thyroidectomies or cancer with the salivary glands in particular the submandibular glands. I really feel uncomfortable with my situation. I have had a CT with contrast done whicChatDoctore back normal. Can you advise me what to do or give me your opinion. [/INST] Your problem is not related to your cancer or to the surgery. They have nothing to do with your present condition. However, they are related to the I-131 treatment that you took. It is known to cause decreased saliva production in both parotid and submandibular glands in a small percentage of patients. This leads to thickened saliva leading to stones or sialolithiasis, swelling of glands, retained secretions, Chat Doctor. If the submandibular gland is just prominent and is not causing you any trouble otherwise (pain etc.), then I would suggest you to ignore it. Also, since the CT scan is normal, the likelihood of this being disease is remote. Other measures that you can take is to keep your mouth wet by using artificial saliva sprays. There is a possibility of stones forming in other salivary glands in which case they will have to be removed. Rest assured, it is not related to your disease. </s>

<s>[INST] I had a recent lipid profile with results as follows HDL 86 LDL 234 Triglycerides 70, my doctor was very upset with these since the LDL numbers have risen since my menopause 8 months ago. I am not overweight, exercise regularly, eat quite healthy(take flaxseed powder 2tbs. daily, along with liposomal vit. c and salmon oil, eat plenty of veggies and fresh orange juice daily... She wants me on medication. I do not think medication is an option until she is willing to test for LDL type a or type b to see if I am truly at risk for heart disease. Where can I get this test? [/INST] Hi, dairy have gone through your question. I can understand your concern. You LDL cholesterol level is high, but there may be some problems in HDL. HDL level of 86 is very unusual. You should repeat your complete lipid profile test after a month. Till that take low fat diet with high amount of polyunsaturated fatty acids. No need to start medication now. Later on if needed you can start Chat Doctor. But right now you don't required medication. Just go for repeat testing. 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 baby is 8 days old and he has Serum Indirect Belirubin = 185 Serum Total Bilirubin = 197 He born prematurely (early) with 3 kg weight Moreover, he remains very tired and sleeps almost for 22 hours a day and hasn t pooped for last 5 days ... what should I do? [/INST] Hi, Welcome to the ChatDoctorSince raised indirect bilirubin level is almost because of some pathological cause, it could be liver disease, obstruction in lower intestine, cystic fibrosis TCAS he has raised indirect bilirubin level and constipation both, first he has to be ruled out for cystic fibrosis and bile duct obstruction and congenital biliary tree sclerosis. My opinion would be got some routine blood tests done, and ultrasonography and x-ray of abdomen done to rule out any intestinal obstruction and discuss further with general surgeon. Chat Doctor. </s>

<s>[INST] I am having pain in my left side of my abdomen sometimes radiating to the center the pain is dull and constant. It hurts mostly when I move but I can feel it when I press on it. region for the last 4 days. I had a low grade fever of 100 degrees It started off a week ago with a severe headache and a sore throat then I was extremely tired. Then I had a bout of diarhea then This pain started. [/INST] Hi ! Good morning. I am Chat Doctor answering your query. If I were your doctor, I would advise you for a routine/microscopic/culture sensitivity test of urine and stool test for ova and cyst. Till the results of the investigations were available, I would advise you with a broad spectrum antibiotic, an anti-spasmodic, a proton pump inhibitor Chat Doctor. This could change depending on the investigation reports. I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing Chat Doctor to clear doubts on your health problems. Wishing you an early recovery. Chat Doctor. </s>

<s>[INST] Hi, I have what feels like a lump in my hip felxor, pretty much in the crease between lower abdominals and top of the quad. One on the right hip is slightly larger than the one on the left hip, and are not in symmetrical positions. When I press on either one they move around slightly, and no real pain just minor discomfort. It almost feels like a knot in a muscle. What could these be? Should I be concerned and should I seek further medical advice? [/INST] Hi, Dear,Welcome with your query to Chat Doctor. Studied your query in full depth of its details. Reviewed it in context of your health concerns. Based On the facts, You mostly seem to suffer from-Lymphnode enlargement in the groin / or could be from Lipoma. Any other causes of such a lump would be more evident after physical and clinical assessment of your lumps in that region. X-ray / USG / CT study would help you out in fixing the cause and nature of such a lump. Surgeon and if need be ortho-Surgeon would help you out in this work up. Hope that, This reply would help you to plan further treatment soon with your treating doctors. Best of Luck and early recovery. Welcome any further query in this regard, which would be replied in next session. Good Day!! Chat Doctor. N. Senior Surgical Specialist </s>

<s>[INST] hello sir,how can i get rid of disease like FITS.. is their is any permanent cure for this................ it keeps with me last 5 yrs.. n fits attack happens on wen i used to sleep...... plz advice wat to do........... i prefer all medical consideration [/INST] Thank you for asking Chat Doctor. My name is Chat Doctor. Dear I would like to inform you that if the fits is diagnosed clinically and with EEG brain then you should take regular Anti-epileptic at least for 02 years. Kindly consult neurology consultant to find out what type of fits you are having so that medicine of choice for your fits can be prescribed, and you can enjoy your life fit free with regular medication. Hope this may help you. Let me know if anything is not clear. Thanks. </s>

<s>[INST] hi, I have kidney stones. Had a CT that showed 4 stones in left kidney that measure 0.7 x0.3 cm and a single faint stone in right kidney measuring 0.2 cm. I have had numerous stones, have never been able to pass any of them on my own. Have had a 24 hour urine and stone analysis that showed calcium oxalate and really try to do the diet recommended. I continue to form stones...the last one about 1 year ago requiring basket extraction. Is this size stone passable without intervention. I have had lithotripsey 2 -3 times and my old urologist said I could no longer do it as there is a risk of shock injury to my pancreas and potential for developing diabetes??? Is this true.? I have a new Dr (because other retired) and he wants to do litho. What are my options? Also, my pain is intermittent at times and at other times is constant and is located right at my Left kidney region. Do you only experience pain when it is in the ureters. Does the kidney itself have pain nerve endings? Can these pass or what is the size stone that is to large to pass. [/INST] HelloThnks for query. You are known to get recurrence of urinary stones mostly due to metabolic disorder. Now you have four stones in Left kidney bigger one of the size of 7 mm. Normally stone up to size of 8 mm can be expected to pass out spontaneously.However, there are multiple factors that govern the passage of stone out 1) Shape of the stone 2) Diameter of mouth of calyx. The pain occurs even when the stone is in kidney and occurs when it gets impacted at the mouth of calyx causing distention of calyx due to accumulation of urine in calyx. As regards no of lithography that one can be subjected to I would say that due to advanced technology and modern lithography machines one can have ESL for plenty of times and there is no danger to pancreas or any other organ. Since you have stone of a size of 7 mm and less you can expect them to pass out spontaneously. If they fail to pass down within a month you can go ahead for ESL. Chat Doctor. </s>

<s>[INST] cervical&dorsal spondilisis cervical disc degegenerative changes and poterior disc herniation from C3-C4 to C6-C7 level with anteriror subarachniod CSF space impingement,e/o ligamentum flavum thickening at D10-D11 level ....mri findings--my complaints r pain in west both knees ,ankles , shoulder wrist with swellings near muscles craps in calf muscles(severe) weak balance cannot stand properly for more than 15 mints. [/INST] Hi, Thank you for posting your query. I have gone through your MRI reports and your complaints. The MRI findings are not severe, and may cause neck pain and pain in the arms. You need to get examined by a neurologist, as well as a rheumatologist. A few blood tests such as rheumatoid factor, ESR, C reactive protein, etc. would be required to find out the cause of joint pains and swellings. As of now, you can take naproxen or ibuprofen tablets for pain relief. I hope my answer helps. Please get back if you require any additional information. Wishing you good health, Chat Doctor. Ly/ </s>

<s>[INST] i think i missed 3 cerezette pills over xhristmas, the days on pack were not matching up so i took the 3 right away that morning i realised i may have missed then and then got back on track after that. the morning i thought i missed them my partner and i had sex... i took a preg test but so far negative how long to wait to take another one? my period is not regular on my pills at all... shall we use a condom even tho i am back on track with the pills? [/INST] Hello, Cerazette is a progesterone only pill. It is common to have an irregular period on this. The protection continues as long as one takes the forgotten pill within twelve hours of forgetting it. The chances of falling pregnant increase if there is a delay of more than twelve hours from when it was due to be taken. Up to two tablets can be taken together if one misses on one day. However, missing 3 tablets puts one at risk of becoming pregnant. It is recommended that one uses emergency birth control measures in such a situation. You could repeat the pregnancy test two weeks after the test that you have taken and tested negative. Or else do a blood test to check for pregnancy hormone level, if you are really worried. Emergency contraception is the other course of action if you realize you have had unprotected intercourse. It could give you 95-99% protection of pregnancy if taken with 72 hours of unprotected sex. Hope I have answered your query. Let me know if I can assist you further. Regard, </s>

<s>[INST] My son is almost 10 years hes good in studies but one month back he was admitted with food infection.After recovery hes complaing again of he cant walk and agin feels like vomiting as hes school time have chaged from afteroon to morning from 7 am to 1 pm i am confused does he need couseling? [/INST] Welcome to the ChatDoctorI have gone through the question and understand your concern. If the symptoms occur only before school timing and improve at other times, its more likely due to anxiety he is facing for school. Counselling will be useful in that case. In case the symptoms are persistent at other times of day as well, then we need to think in organic cause of illness such as vitamin deficiencies, gastritis or worm infestations. You may deform him by Albendazole or nitazoxanide in that case and start him on Lansoprazole before breakfast for a few days in such case. Also, assure a healthy balanced diet with lots of fluids. Hopefully this will help. Take care </s>

<s>[INST] Good day Dr, Ive had pain for a week in my throat, no whiteness (infection) just a lump thats very irritating and painful. Cannot swallow, sleep nor breathe well. Also facing a lot of uncontrollable anger at the moment. I am a smoker. Could this be cancer? I freaked out because google pictures match. [/INST] Smokers are always at risk for throat cancer and a variety of other cancers. The symptoms that you have described are suspicious for cancer especially in the setting of your smoking habits. However, this is not definitive, and it may just be a throat infection which you cannot see with naked eye. All you need to do is consult an oncosurgeon and get an endoscopy done. This is an OLD procedure and will settle the issue. Also, try to quit smoking and a lot of your problems will be solved including the anger. </s>

<s>[INST] Ive had the contraceptive implant inserted in my arm for 6 months now, it was inserted at the back of my arm rather than the front side and i was recently hut quite hard where my implant is and it has moved deeper and round my arm some more. It gets quite itchy and i also ive started to be sick frequently and have put on weight, i was wondering if it is effective still? [/INST] HAI, Thanks for using Chat Doctor. Contraceptive implants have some side effects, at the insertion site. Mild itching, discomfort & mild pain is common. If you have redness, swelling & oozing at the insertion site consult your Doctor who have inserted it. Weight gain is a common side effect of Implant, because of the Hormone content in it. Implants are effective up to three years. What you have, are all side effects of implants. If those complaints are much disturbing, consult your Doctor for counselling and evaluation if they feel it is needed. Chat Doctor. </s>

<s>[INST] Hi, I had unprotected sex on last Thursday and Saturday and I had emergency contraceptive pill on Saturday. my periods were due on Saturday. I still havent got my periods and I am feeling pukish and lethargic. is there a chance I am pregnent or is can be a side effect of the pill. I am also having brown discharge everyday since Saturday. [/INST] Hi,First, you cannot get pregnant with an intercourse just before the onset of period as ovulation occurs 14 days before the onset of a period and this is the fertile period which can cause conception. Moreover, emergency pill contains excess hormone and this causes disruption of the normal hormonal milieu of the body. This results in breakthrough bleed, menstrual disturbances and delayed periods. If you do not see a period even 10-14 days after your period is due, you should see a specialist for further help. Hope this helps. </s>

<s>[INST] I HAVE A VEIN ON THE LEFT SIDE OF MY CHEST THAT IS VISIBLE AND IS SORE. I JUST HAD A STRESS TEST DONE AND EVERYTHING IS NORMAL WITH MY HEASRT. THE AREA IS VERY SORE TO THE TOUCH. I ALSO HAVE BEEN HAVING FLUTTERING SPASMS JUST UNDER THE LEFT BREAST AREA. I AM A 53 YEAR OLD MALE. [/INST] Thanks for your question on Chat Doctor. I can understand your situation and problem. No need to worry about heart diseases because your stress test is normal. Possibility of skin infection like herpes zoster is more in your case. It is viral infection of skin caused by skin contact. It is commonly seen in chest area. Herpes causes pain, redness, itching and venous engorgement (dilatation of veins) in localized chest area. So better to consult dermatologist and get done clinical examination of your local part. You may need antiviral, painkiller and anti-inflammatory Chat Doctor. Hope I have solved your query. Wish you good health. </s>

<s>[INST] My sister is in hospital with pneumonia, and ive just got the message from family who visited last night that she may have the Strep Milleri virus. My question is.... which way round is this? Does she has Strep Milleri as a result of pneumonia or has she got pneumonia because she had the Strep virus? thank you [/INST] Hello dear, Thank you for your contact to Chat Doctor. I read and understand your concern. I am Chat Doctor answering your concern. No, Streptococcus Miller is not the virus, but it is bacteria. It Grams positive cocaine infection caused by these bacteria is pneumonia. Viral infection may be primary agent of infection, but chances of pneumonia is caused by Streptococcus Miller is more. I advise you to get bacteria sensitivity done. And take the Chat Doctor. </s>

<s>[INST] facial skin peeling and redness by skinlite cream by liva i use skinlite cream but i have facial redness and i am scared that the facial red atea should turn into a black spot what should i do.skinlite cream contains hydroquinone+tritrinone+memethasone furate. [/INST] Hello thanks for posting, SKINLITE CREAM is mainly used if any underlying pigmentation is present. It has to be used in very little quantity(only on concerned area) only at night. Excess use causes redness and peeling of skin. Suggest you to use a moisturizer one hour after applying skin lite and a sunscreen morning and afternoon of SPF 30. In case if you are using skin lite as fairness cream for complexion improvement advice you to stop it. </s>

<s>[INST] I have anxiety and ptsd due to severe abuse as a child. I am studying to be a writer and I got really stressed; had to stay up all night the other night to write a paper that was due the next morning. Since then I have felt like I have the flu and my entire body has been tingly. Dont have the flu. I got the shot. I took some Ativan and some Aleve just now. Is there something else I should do for this anxiety period. It will go away eventually, but I hate feeling like this and its scary. [/INST] Hello, Thanks for choosing Chat Doctor for posting your query. I have gone through your question in detail and I can understand what you are going through. Anxiety requires treatment with Escitalopram or venlafaxine. Flu requires treatment with paracetamol. Hope I am able to answer your concerns. If you have any further query, I would be glad to help you. In future if you wish to contact me directly, you can use the below-mentioned link:bit.ly/ Chat Doctor. </s>

<s>[INST] l am almost 50 years old female l recently under a lot of stress had some bloods taken am now having vit 12 injections and taking vit d tablets l have lost a lot of weight not felt like eating with the stress my appettie has improved l have a very healthy diet l have numbness and tingling in my hands and feet and a unusal sensenation below the knees l have being diagnosised with raynaud disease some years ago l often feel nauseas and really unusual coppery taste in my mouth l often have foggy feeling l dont drink alcohol very often l am smoker l dont have diabetes or any other known illness [/INST] Hi, I would suggest the following tests if they have not been done earlier. Complete blood count, peripheral blood smear, blood Urea serum, liver function tests, creatinine, urine routine examination, lipid profile, thyroid function test, fasting blood sugar., ANA. I presume that you have been prescribed vitamin B12 because your vitamin B12 is low. A deficiency of vitamin B12 and vitamin D do produce the symptoms you have described, but it is also important to rule out Diabetes mellitus and thyroid problems as well hence I have suggested a battery of tests. The Maynard type of symptoms may have no cause in which case its idiopathic, or it may be secondary to autoimmune diseases. Your Vitamin B12 deficiency may be nutritional or immunological such as pernicious anemia. Depending on the cause of your vitamin B12 problem you may be treated as a short course of vitamins or life long if it is the pernicious anemia type. If all tests are negative the Reynolds phenomenon may be alleviated by keeping your feet and hands warm by gloves and socks and also avoiding cold temperature. It is important that you should get your feet examined for loss of pulses and peripheral neuropathy. As a precautionary measure avoid walking barefoot and avoid immersing your limbs in hot or cold water. If your lipid profile shows abnormal values that has to be treated either through dietary modifications for mild values or lipid lowering Chat Doctor. Protection of hands and feet from injury is essential. Smoking aggravates Reynolds. As you have expressed that you do not have diabetes or any known illness I presume that you have done most of the lab tests. If it has been a long time since you had the tests it is prudent to get the tests done now. Should you require further information please post your lab test results and further clarifications here so that I may assist you in getting all the information that you need? Best regards </s>

<s>[INST] I was it in head today at hairline temple...I am in Nicaragua three hours from hospital...veins are popped out have two eggs on front of forehead and on side of eyebrow...I am calm now. Had ice on and off all day. Have headache and threw up early but not for several hours now...I am tired but don t want to sleep...it is so far and a very bumpy wet dangerous drive for me flight...think I have blurred vision but not a lot of pain...I am crying...guess that is pointless. Thanks for your support...I am ALS praying Feel better sitting up than down...more veins pop out etc... I took Stasi am cause I was panicked. What else? Should I ice more? Set an alarm every couple hours etc? Thank you so very much...I am basically alone [/INST] Hi, Dear , thanks for the query to Chat Doctor. I studied your query in-depthj and feel concerned about the sufferings you have. I would advise you not to lose patience due to ALS and the painful bumps with severe headache for hours. Till the time you get the medical ER care-I would advise you to follow health tips to relive yourself-a-Continue-Cold-ice packs locally on forehead and eyebrow bumps.b-Tb.alpha to calm your nerves, c-Consult Surgeon-when you reach ER-services,who would get the CAT scan, and get the neurosurgeons opinion for the blurred vision, d-a 50% Glucose Chat Doctor. E-Dont lose your inner strength, which is the most-important booster for the healing of your illnesses-head injury with ALS.f-Take deep and rapid-breaths, which would reduce IC pressure, by hyperventilation. Hope This would resolve your query. Well come again for any more query. </s>

<s>[INST] My Father (60Yrs) old is suffering CA colon from 2005 and opt RT Hemicolectomy on 04/21/2005 after six Chemo .he was well.again 2010 he suffering pain & got Ca colon & again surgery on anastomosis site on 07/10/10. Now again four chemo completed & again biopsy report showing adenocereionoma with ulceration. so please reply me whether he need another surgery to remove infection. [/INST] Hi and welcome to Chat Doctor, thank you for your query. You said that there was verified adenocarcinoma again, not infection and in this case he needs surgery definitely unless there are some contraindications such as liver metastases or other site metastases. So always when there is evidence of recurrence of malignant disease, it should be removed surgically followed by chemo. Wish you good health. Regards </s>

<s>[INST] i have been having pain in the middle of my chest off and on for a few months now. over the past week or so i am having worse chest pains that last most of the day off and on. sometimes it is sharp pain today it is dull and achy and my back is sore too [/INST] Hello. Thank you for your question and welcome to Chat Doctor. I understand your concern. Well, I am going to try and explain the differences between various origins of the pain which can arise from the rib cage. There is angina. It is described more like mid-chest heaviness or squeezing sensation, that is triggered by exercise and relieved by rest, which radiates to the both sides of the chest, to the jaw and left arm and shoulder. It is indicative of a blockage within one or more coronary arteries and reflects the lowering of blood supply to the heart muscle. An EKG obtained in the moment of chest pain, if it fills this description, would be helpful. Then there is pleuritic chest pain. This kind of pain is sharp, stabbing pain that can happen in any part of the chest area. No radiation like in anginal pain. It arises from acute or chronic inflammation of the linings that are within the rib cage: pleura (lining of the lungs) or pericardium (lining of the heart) or both. In this regard, I would recommend a chest X-ray for pleural inflammation or effusion. In case of pericardial pain and anginal pain, echocardiogram is helpful, by evaluating the size, motility and function of heart muscle and valves, and also by assessing the pericardium and whether there is fluid build-up within it, or not. Other causes of chest pain are related to the locomotion system of the rib cage: muscle soreness, bone and cartilage-related pain. In the end, stress can also cause chest pain. I hope I was helpful with my answer. Best regards, </s>

<s>[INST] Hi, I had the bcg vaccine yesterday and the vaccine site is already swollen and full of pus. I have read reports that this usually happens after a few weeks but nothing about just over 24hrs after vaccination. It this normal or is it infected? Is it a problem if it bursts so soon after the injection as I think this is likely to happen? Thanking you in advance. [/INST] Hi. Welcome to Chat Doctor . I have gone through your query and can understand your concerns. As per your complaint redness, mild bruising and pain at the infection site can be seen commonly after injection for about 3 to 4 days but in case if the area has a pus filled bump it is a clear sign of infection and needs to be treated. You should consult a general physician and get evaluated and in case of infection he can advise you to take antibiotics and if the lump is large Chat Doctor. . It will be followed by cleaning the area with antiseptic solution and apply a triple antibiotic ointment. Keep the area clean. Hope this information helps. Thanks and regards. </s>

<s>[INST] im 15 and have always been really shy and nervous but over the past 3 weeks its got a lot worse im fine at home but when im out i cant speak and it feels like the words are stuck in my throat i can talk to people i know really well but not in groups of more than about 3-4, it seems to worse everyday and even if im taking to my form tutor at school for a long time i have to force myself to speak, i really hate it and i don t know what to do about it or how to explain it to my friends [/INST] Hello, Social anxiety is commonly due to fear, fear of being criticized, fear of meeting people, fear to hang around with friends, tendency to avoid people, having a blank mind (not knowing what to talk), etc. It is basically because you are very sensitive, self-conscious & get embarrassed too fast. Try to be less sensitive, confident, don't think what people may say and be expressive. When you make a mistake, don't get angry or embarrassed rather laugh at it when others laugh so that slowly you get comfortable and your friends start enjoying your funny company. If you think you lack topic to discuss or talk, buy joke books (read it) and start cracking jokes from time to time. Everyone loves a happy person. Social anxiety is a fully treatable and can be overcome with effective therapy, work, and patience. Physical, sexual, or emotional abuse in the childhood sometimes make people anxious, come out of your hurt, fears and bad memories. You can contact a counselor or a psychotherapist, cognitive behavioral therapy is effective. It will help to build confidence, learn skills that help you manage the situations that scare you most, and then get out it faces the world comfortably. Avoid people with whom you are not comfortable, stay positive about yourself, do not undermine yourself, cut on addictions if any. Stay well nourished and well HY Chat Doctor. Medicines like SSRIs may help, you can take it initially for a few days after getting clinically assessed by a GP. Do not depend on medicines, the symptoms may get worse because of dependency. Switch to healthy lifestyle, do exercises, make new friends, stay cheerful. Never let negative thoughts overtake you. Never get hopeless. Every individual is unique and beautiful. Hope I have answered your question. Let me know if I can assist you further. </s>

<s>[INST] I have a 2months old pet dog in my house . He is not vaccinated. Few days before he scratched my 4yrs old son. It ws just a minor wound. I have started anti rabbies treatment After 5days.three doses r complete nw. Should I need to continue rest of other two doses. Be coz I heard tht if the dog is not rabbid then later on it will effect my son dangerously . Is it true. [/INST] Welcome to the ChatDoctorRabies is a vaccine-preventable viral disease which occurs in more than 150 countries and territories. Infection causes tens of thousands of deaths every year, mostly in Asia and Africa.40% of people who are bitten by suspect rabid animals are child Chat Doctor. Dogs are the source of the vast majority of human rabies deaths. Immediate wound cleansing and immunization within a few hours after contact with a suspect rabid animal can prevent the onset of rabies and death. I would strongly suggest you to complete the whole course of anti-rabies injections. If the dog is not rabies infected, then there is nothing to be worried about. It's important to get completely vaccinated because it protects your child completely and also in case he is exposed again later in life the number of injections will reduce to just 2 in number. For any further questions, do contact us. </s>

<s>[INST] Hi doctorAm 22years old guyPlz tell me the benefits of sunath surgery and how long it I Ill take to cure How many days needed for bed rest and after tat can I got to office regularly or need a lot of restAnd can I mange my slef alone Without anyones help [/INST] Degree understand your concerns went through your details. Sunbath surgery is called circumcision. Circumcision is the surgical removal of the foreskin, the tissue covering the head(glans) of the penis. There are some potential medical benefits of circumcision in terms of a slightly lower risk of urinary tract infections (Otis) in little boys, certain sexually transmitted infections in men, and penile cancer. From the day of surgery, within two days you can do your normal day-to-day functions. Within 15 days everything will be perfect. You will not be having anybody else's help, and you will be able to manage alone. 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] Since my 5-year-old daughter was an infant she gets rosey red cheeks and has started to develop small pimples in those areas. Is there anything that can be done? Could it be diet related. Is it eczema? Are there any over the counter medications that are safe to use to clear her skin? [/INST] Hi...by what you quote I feel it could bean eczema itself. I understand your concern. The trick of the management is keeping the skin moist and never allowing it to be Chat Doctor. For this oil massage and lotions like Hiatus will help. Eczema is a sort of allergy...allergies can only be controlled and can never be cured. But usually kids grow out of it...that is as the age progresses. But to be sure that it is eczema and nothing else, I need to see the images as skin conditions are best diagnosed by seeing them. I suggest you upload the images in this website so that I can guide you scientifically. Regards - </s>

<s>[INST] i missed my period and took 3 pregnancy tests, whicChatDoctore back positive. a week later my period came with abnormally big clots and white/greyish tissue. i suspect im having a miscarriage. it has been 4 days since i started bleeding and i m still cramping and passing clots. do i need to go to the hospital if i were only 3wks pregnant or will it just pass? [/INST] His have gone through your complaints. You are saying you missed your periods, and positive pregnancy test & now passing grayish vaginal discharge with blood clots means its miscarriage only. Its important to consult doctor to assess whether complete abortion has happened or any retained products to evaluate cause for abortion. What is your general status like whether you are anemic, evaluated when you meet Chat Doctor. </s>

<s>[INST] My wife has been following medicines for last 6 months for depression.Lithosun SRDaxid 50mgOpiprol 50Modalert 200.For last one week her condition is little bit worse.Can anyone help me what to do?My doctor just prescribed to stop all medicines except Lithosun.Is it enough to keep her normal? [/INST] Hello have not mentioned the dosage of without. Moreover, i donor think that presently lithium alone can be sufficient. In my opinion her David should be increased to 75-150 mg daily dose, and stop opinion (as it is not desirable at all in her case). Get the lithium levels done, if it is less than it will be good to increase her lithium dose. Continue monitoring her condition. She should start showing improvement in about a week. Ask her to take more water and salad. May continue mod alert for some time and when she GES better stop that. Hope this helps you wish you good luck. </s>

<s>[INST] Do I need a urologist or a nephrologist for treatment of renal tuberculosis? I live in Texas and Im having trouble locating a physician in this speciality. All the physicians that Ive called have not treated anyone with this. Would you please give me names/locations of a physician/s in Texas that has or had experience with renal TB? Thank You, Judy [/INST] Hello welcome to Ask A Doctor service. I have reviewed your query and here is my advice. Uncomplicated renal tuberculosis can be treated by nephrologist doctor. Anti tuberculosis therapy should be started for that. If renal tuberculosis is complicated with abscess formation in kidney than urologist consulted as Chat Doctor. Kindly mention your reports for giving more comment. Hope I have answered your question. Let me know if I can assist you further. </s>

<s>[INST] Hi, I have had a really bad cough for four weeks now. It started with long coughing fits in the day and these have reduced but have been added to by coughing fits at night which feel like they go on for ever. Also during these I cannot breathe in which initially caused me to panic but I found I could breathe in if I calmed down but this took some time. Chemist gave me a Ventolin inhaler to open airways during attack which helped a bit. Also I have an almost constant tickling sensation in the back of my throat and at night for the last week my chest has felt tight - ventolin inhaler has helped relieve this. Finally I feel like something is stuck in the right hand side of my throat but cant normally cough it up as cough is generally unproductive, except first thing in the morning when I am able to cough up some clear phlegm but also tend to vomit as well. Occasional dry mouth at night doesnt help. Really getting fed up with this now - went to doctors two weeks ago who thought I had the after effects of a viral chest infection and thought it would all clear up within a week - now two weeks on there is no sign of this. Can you advise? Thanks [/INST] Hi and thank you for choosing Chat Doctor to post your health concern. I read carefully your question and my opinion is as follows:From what you describe it seems to me that all these paroxysms of intense coughing lasting up to several minutes, the tendency to vomit after cough(possessive vomiting) and the duration of cough(4 weeks) match with the clinical presentation of pertussis infection. I don't know about your vaccination status (incomplete or absent pertussis vaccination)Pertussis is a respiratory infection that lasts about six weeks, starting with a catarrh phase followed by a paroxysmal phase and convalescent phase. Vaccinated adults usually develop only prolonged bronchitis. Treatment usually involves an antibiotic, but it only helps if administered in the first or second week of symptoms. In your situation Ventolin inhaler that your doctor prescribed helps to reduce the paroxysms and would help also if you start antitussives such as dextrometorphan, codeine.another less possibility of your health problems is even the beginning of an asthma since very frequently it can be precipitated from a viral infection. It would help me to support this if I would have a well given medical history(allergies, familiar history of asthma)and physical examination Spirometry is useful for diagnosis and the treatment need to be guided by its value. I hope my opinion is help to you. Wish you good health. Kind regards Chat Doctor. </s>

<s>[INST] My daughter is almost 2 several months ago she started having very frequent bowel movements. Like 30 a day. but they are incomplete bowel movements, more like a fart and a little poop comes out that it.. she has been diagnosed with strep on the anus although her bottom seems to bl clearing up its not helping the frequent bowel movements. she cries and has a straining stance with her legs locked stiff and really looks like it hurts coming out i dont know what it could be or how to help her [/INST] Hi, Welcome to Chat Doctor forum, I am sorry to hear about your children condition. I am sure it must be really painful for her. The frequent bowel habits seem to be due to the pain she has in the anal region. You need to take here to a pediatric surgeon for a complete evaluation of her anal region and if needed a copy study too. Hope I answered you query adequately. Let me know if there is any further clarification you need. Take Care. </s>

<s>[INST] hi Doctor,My name is Nidhi. I have dark and light brown dots on my face. I believe it is due to the sunlight exposure. These brown spots are on my face since my early teenage and now I am 26 yrs old. please tell me how to make them disappear from my face. I am fair, so have these seen very clearly too. Thank you in advance for helping me soon.Nidhi [/INST] Hello and welcome to Chat Doctor You most probably have freckles on your face. Freckles are flat, brown to tan males which are common in those who are fair skinned. They appear most prominent in sun exposed areas and Sun exposure tends to darken them. For freckles, you could use Bolivia gel during daytime and Aramaic acid gel (Aider) for nighttime use. You can also opt for chemical peeling session from a dermatologist. Glycol peel and Comic acid peel can both effectively diminish freckles. Always use a broad spectrum sunscreen gel, 1/2 hour before stepping out in the sun and regularly throughout the Dayan Oral It C supplement would also help with pigmentation. Regards </s>

<s>[INST] A few months ago I developed what my dentist called extreme jaw disfunction. I had a night guard made for my lower teeth. About 3 weeks after wearing it my neck started to crack when I moved it either sideways or even up or down. Sometimes I get a star burst feeling in the back of my head after a loud crack which can be heard across the room that I sit in. Sometimes I have a light headed feeling too. Do you have any information about this. I am seeing a cranial massage therapist whom I am hoping can help me. Thankyou. [/INST] Hello, Your night guard is designed to prevent some stress to your jaw and preserve your teeth. Are there other dental treatment recommendations made by your dentist to ad Chat Doctor. You can consider seeing other dental specialist including an oral surgeon and orthodontist. X-rays and scans may provide additional details for a diagnosis. I am concerned that you may at risk with some nerve damage in your neck. This may require an evaluation by a neurologist or orthopedic doctor. Do you have a history of any back or neck trauma? This can include a fall, car accident or sport activity. A chiropractor may offer you relief and take X-rays for diagnostic information. Anti-inflammatory medication may assist relief for muscle tension. I suggest you discuss additional steps with your dentist and the massage therapist. Thank you for your inquiry. I hope you feel better soon. I am available to answer additional questions if you can provide your medical history and further description of your condition. </s>

<s>[INST] The patient is my father-in-law. He has just been diagnosed with prostate CA with Gleason score (4+5 = 9/10) and with mets to D2 and D3. He is suffering from constipation and severe bone pain at the aforementioned level. He weighs 43 pounds and approximate height is 5 feet 3 inches. He has almost zero appetite. What is his prognosis? He also complains of constipation and left arm numbness. Are these symptoms associated with CA? [/INST] Hi, dairy have gone through your question. I can understand your concern. He has Prostate cancer with Gleason Score (4+5 = 9/10). Prognosis is very poor. Gleason score more than 7 is indicator of poor prognosis. He also has bone metastasis. So prognosis is very poor. Life expectancy is not good despite all treatment. His other symptoms are due to his cancer. So only symptomatic treatment is given at this stage. Consult your doctor and plan accordingly. Hope I have answered your question, if you have any doubts then contact me at bit.ly/ Chat Doctor. Thanks for using Chat Doctor. Wish you a very good health. </s>

<s>[INST] My husband has fallen on an electric toothbrush while it was standing up right in its holder. The metal went all the way into the side of his knee, Im worried of infection, but he doesnt want to go to the hospital. Can u recommend anything please? [/INST] Hi. Welcome to Chat Doctor . I have gone through your query and can understand your concerns. As per your complaint as your husband has fallen over an electric toothbrush that has gone inside the knee leading to formation of a wound. It can lead to mild infection in the area but the infection will not be so severe that you need to be too much worried about. You need to simply start cleaning the area with an antiseptic solution and apply an antibiotic ointment over it to avoid infection. Keep the wound clean and Chat Doctor. . In case if the condition worsen or there is pus formation or pain, consult a General Physician and get evaluated, and he can advise you oral antibiotics. Hope this information helps. Thanks and regards. </s>

<s>[INST] My son is 2 yrs 6 months. Diagnoised with severe chest congestion and cough mucolytic. Doc said mild bronchitis. Prescribed Ascoril syrup 3.5 ml 3 times a day for a week. After giving medicine cud see some restlessness and adamancy at night which was uncontrollable. Now 4 days over. He is better but a bit dull. His cough though l not fully gone but bettet. Is it normal [/INST] Thank you for consulting in Chat Doctor. The condition that you mention, is probably bronchiolitis and not bronchitis. It is a viral infection that affects child Chat Doctor. It is characterized by chest congestion and wheezing. In order to dilute the cough steam inhalation or nebulization is required alongside the Multics. Generally it is associated with an allergic component for which the antiallergics like Astoria are given. The side effect of such antiallergics is </s>

<s>[INST] Hallo Mia, I am really sad and depressed. I am overweight and I want a child so bad. Because my gynocologist could not acces my eggs she suggested I use progynova. I wonder what my chances are to conceive. I have had 2 ivf invain. My husband has a very low sperm count and thats why we have to go through this proces. I am 38 and surely getting worried. [/INST] Hi there ~ I understand your concerns. I also feel like you need to visit with a psychiatrist to get the right medications and get a referral to a good therapist or counselor who can get you the therapy needed to get out of depression. I am glad you ask this question on this forum and I hope you visit with a psychiatrist as soon as possible. Furthermore, I also think that you might need IVF treatment which might just be the solution you are looking for. Furthermore, I hope you consult a specialist in this area. Take care and have a lovely day! </s>

<s>[INST] Hi, I felt a lump in 08/2012, had a mammo and u/s in 12/2012, 01/2013 had bx and it was a fibroidadenoma. had f/u mammo and u/s in 2/2014, another lump was found...they said to f/u in 08/2014 for another mammo and u/s. since 02/14 I have had breast pain and now underarm pain x 3 mos. advice? [/INST] Welcome to ChatDoctorThis is called fibroadenomas which is benign condition and may be painful at times. This is related to your period and due to hormone imbalance. For armpit lump that is lymph node you require needle biopsy. For painful breast lumps take tablet Even 400 mg daily for one month and painkillers during more severe pain. Good breast support bra should be used. But if armpit biopsy comes cancer you need surgery for breast along with armpit lymph node clearance. Regards </s>

<s>[INST] 7-year-old vomits, usually at night 1-4 hours after falling asleep. Feels better after vomiting once or twice. No fever. Grinds teeth in her sleep. Vomits up to three times a week, but sometimes goes three-four weeks without vomiting. Fine in summer, June-October. Happens all winter long, every year. Doctors find nothing. gagged easily as infant. breastfed first three years. milk intolerance but not allergic. [/INST] Hi.... I understand your concern. By what you say I feel that she might be having a gastroesophageal reflux which is a comorbid condition, along with some allergic bronchitis. I am associating this with allergic bronchitis, as you say this is happening only in the winter months. Sleep bruise is quite common when there is worm infestation. I suggest you consult your pediatrician and ask for anti-reflex therapy with this tip. I feel she will improve with anti-reflex therapy. Regards - </s>

<s>[INST] I recently had my rook pierced, everything was fine the first few days; about the fifth day my ear had gotten an infected because I let me hair down. It has puss coming out of it, is swollen and also hurts. I get headaches and the infection hasnt seemed to improved, its been a week. What should I do? [/INST] Hi Dear, welcome to Chat Doctor. Understanding your concern. As per your query you have symptoms of swelling and infection in ear and headaches which is due to fluid accumulation behind the ear Chat Doctor. It could be due to Eustachian tube misfunctioning as well. Need not worry. I would suggest you to consult an Otolaryngologies and get evaluated. You should go for endoscopy examination as well to find out cause and exact extent of infection. You need not get impatient. Furthermore, you should take antibiotic and anti-inflammatory </s>

<s>[INST] My mom had very severe anemia Hg 5.8, She was admitted to the hospital, they did a no.of tests on her and found her ESR results were high, but the immunoglobins test was negative. she had her physical examination of the lymph nodes in her chest and abdomen and they were normal, doctor had seen some swollen lymphs in the xray, could she be suffering from lymphoma. her iron is 2. [/INST] Welcome to Chat Doctor. Severe anemia itself a cause of high ESR. On the basis of swollen lymph node we can not diagnose lymphoma. Tuberculosis can also cause chronic anemia and high ESR with enlarged lymph nodes. You should not be worry. I suggest you that your mom really need a full work up to confirm diagnosis. You should also mention complete blood count report including peripheral blood film with duration of illness. Thanx for query. </s>

<s>[INST] Recently I have been feeling faint, stood up once this weekend and almost fell over. I had to hold onto a door, just not to fall over and knelt back down to recoup. I have also had slight pangs on both my left and right side towards my back. I don t know if my blood pressure being low( culprit) for the faint feeling? [/INST] Hello! I read your question and understand your concern. There are many causes of dizziness and fainting. The most simple thing would be a low blood pressure or an orthostatic hypotension. I would recommend you to measure your blood pressure regularly and in two positions, sitting and standing up. A decrease more than 30 mm Hg from sitting to standing position would be indicative of orthostatic hypotension. Another cause would be a vertebral artery insufficiency or from cervical spondylarthrosis causing compression of the vertebral artery. It would also explain the back pain. A cardiac arrhythmia can cause similar symptoms too. I would recommend you to consult with your GP, have a full blood work to rule out anemia. A Doppler ultrasound of the cervical vessels and a cervical column X-ray would also be needed. Other tests for the heart like a 24h ECG monitoring, and a Heat up tilt test for orthostatic hypotension may be necessary. Hope to have been of help! Best wishes, </s>