Datasets:

rohanbalkondekar

/

HealthCare

like 0

<s>[INST] Hi. I have had a sharp pain that is located behind my left shoulder blade and sometimes travels down my left arm. It acts up the most when I am sitting at my desk at work and gets worse as the day goes on until I get home to rest. It does not hurt when I am sleeping. I m thinking a pinched nerve. I had this problem 2 years ago. I went to get checked and x-rays showed nothing. It went away after a few months and last year I was fine. Now it s back. Please help [/INST] Hello and Welcome to Ask A Doctor service. I have reviewed your query and here is my advice. Considering the fact that you had this shoulder pain two years ago, that you have it during your work sitting at the table, and it gets worse as the day goes on. In my opinion your complaints might be related to a cervical pinched nerve due to a disk herniation, or it might be related to rotator cuff problem on the shoulder joint. These problems both are commonly accompanied by shoulder pain that radiates to the arm or hand, and it gets worse by bad posture. To put the right diagnosis you should consult a doctor for a physical examination, and MRI is the best examination to diagnose these problems. For pain relief you can try taking Naproxen, (anti-inflammatory Chat Doctor. Exercises and physical therapy also help and try to keep a good posture during your work. Hope I have answered your query. Let me know if I can assist you further. </s>

<s>[INST] I ve been experiencing these strange occurances. It starts with really hot flashes to my face and it stays hot and red for a while. Then I get a rapid heart rate and dizzy spells/light headedness. Then it turns into a slight headache. I am on blood pressure medication Procardia XL and have been on it since August. What could be my problem? [/INST] Hello, I passed carefully through your question and would explain that your symptoms could be related to high blood pressure values. For this reason, I would recommend you to closely monitor your blood pressure values during these episodes. I would also recommend performing some blood lab tests (complete blood count, PCR, ESR for inflammation, thyroid hormone levels for thyroid gland dysfunction, blood electrolytes for possible imbalances). Hope I have answered your query. Let me know if I can assist you further. Take care Chat Doctor. </s>

<s>[INST] hi, i have been having some health issues for over a year now. weight loss, bloating, gas, pelvic pain, lower back pain, diarrhea on and off, recently had abenign polyp removed from the neck of my womb and 3 colon polyps removed, still waiting on the results for colon polyps, i have a follow up in march 2 get results so they must be benign. well i have had a hard painless lump on my left ribcage between the 9th and 10th rib for over 4 years i think, it doesnt move but im sure its grown some. what do u think it could be? im 37 female [/INST] Thanks for posting your query to Chat Doctor. As I understand you are having problem in different system of body. I tried to save your query .painless lump on rib cage could be a benign mass for which you need to undergo ultrasound and biopsy examination under guidance of Surgeon. Pelvic pain and lower back pain could be due to muscle spasm which require opinion of an orthopedic surgeon. Gastric trouble could be due to your food habits, so you need to manage your dietary habit.thanks . </s>

<s>[INST] Help! Please... I have been diagnosed by Mayo with pelvic floor tension myalgia, IBS, and IC... these have proven to ge totally disabiling 2 or 3 days every week. I ve tried so many medications, accupuncture, ice packs, high-fiber, gluten-free, whatever, whenever... Nothing is helping. Any suggestions? [/INST] For pelvic floor tension Sylvia along with IBS, you have tried with medication, fiber rich diet and hot and cold pack also. I suggest you should take physiotherapy treatment along with this. There are specific treatment available along with exercise therapy which can help you a lot with IBS and pelvic floor tension Sylvia. It will be more effective again when you do a combine treatment along with medication, diet management, and use of hot and cold pack. I also suggest improving your lifestyle and food habits in terms of timing and add more colors by adding more fruits and vegetables in your diet, add omega 3 along with fiber in diet. Do regular morning and evening exercises as guided by physiotherapist. As well take proper medication as directed by your doctor. Mylgia is basically pain in muscle due to over strain, so I also suggest to practice meditation and try to control your bodies natural normal functioning along with that with power of meditation and body healing. Here I have given you general guideline but bi am sure this will definitely help you if you follow properly. Take care. </s>

<s>[INST] my toddler is breathing very fast. He has had a cold and is now coughing. Last night he could not sleep properly because of his coughing and labored breathing. His chest and throat moves up and down really fast when he breathes. Should I take him to the hospital to check for asthma or pneumonia? [/INST] Hi Dear, Welcome to Chat Doctor. Understanding your concern. As per your query you have severe cold and shortness of breath which could be due to severe upper respiratory track infection/lung infection, and it could be sinusitis. I would suggest you to do warm saline gargles and Betadine gargles alternatively, avoid eating spicy and heavy food. I would suggest you to consult ENT specialist for proper examination. Doctor may order throat swab test, viral culture test and blood test. Doctor may prescribe anti-viral (acyclovir) along with anti-inflammatory Levocetrizine. Chat Doctor. </s>

<s>[INST] hi, this is sonam here,i stay in bangalore...we are trying for baby from last 4 yrs bt nt yet succeded...n i have pcod n my husband sperm count is average....n m taking all hormone injections with siphene for 5 days bt still no result...waht to do? [/INST] Hi sonar, Thanks for writing to Chat Doctor.since you have tried sphere with other hormones like SG or pride I suggest you to get your tubal patency test. If your tubes are normal then you can go for GUI. It is intrauterine ingestion of sperms. Here sperms are washed and processed, and healthy sperms are placed in uterus. This will increase chances of pregnancy. Also since your husband sperm count is less only good sperms can be collected for GUI. You can try 5 to 6 cycles of GUI before proceeding father. Once GUI fail then you need to go for IVF. Regarding average sperm count I suggest your husband to take multivitamin with zinc combination. And reduce weight, do exercise, stop alcohol and smoking. Hope I have been helpful . Regards Chat Doctor. </s>

<s>[INST] My 4 month old daughter has had a rash all over her body for about a month now particularly on her chest and under her neck and i have been to the doctor a couple of times with it, the first time they said it was heat and this time they said it could be viral or mild eczema and gave some immolient cream, which ive been applying but its getting worse and her skin is turning leathery. but heres the weird thing, it doesnt bother her in the slightest!! shes the happiest baby ive ever known, and ive always thought ecema was itchy and painfull? the other thing concerning me is that she has a growth under her skin by her right eye (quite large) the consultant thinks its a strawberry birthmark under her skin (its not coloured) but i cant help wondering if its all connected? ive also noticed the past few days her hands & fingers are blacky/purple in the morning and fine the rest of the day. I dont mean to sound paranoid, im not an OTT mum as i have a 5 year old who is rarely ill, but my mums instinct is saying this rash is something else but i dont know what!! [/INST] Hello!yes the doctor is right, its childhood eczema. Childhood eczema is not that painful but yes its scaly and itchy at times but not that much. You should follow your doctors advise. The growth you are talking about is probably strawberry hematoma, and it has got no harm to the baby. And what you are talking about the hands is pretty normal. Babies can't adapt quickly to cold temperature, they have constriction of blood vessels in hands during cold so it doesn't get oxygen for some time and gets blue. </s>

<s>[INST] Hi! I am 51 and 115 pounds...I am 28 years old and a mother of three. Besides my kids keeping me crazy busy, I also highly active/high paced job where I am on my feet straight for at least six hours a night. I do high intensity workouts about five days a week consistantly. My blood pressure has always been normal but these last few months it has been low. My last check up it was 92/70...my doc said it was ok...but im wondering if there are maybe other things i should be watching out for. My heart rate always seems to be fast, even when imaying down?? [/INST] Hello! Welcome and thank you for asking on Chat Doctor! I understand your concern and would explain that low blood pressure could be related to different causes: - chronic anemia- deny Chat Doctor. . I would recommend performing some tests to investigate for the possible cause: - a resting ECG (as you refer to have a fast heart rate)- blood lab tests (complete blood count, blood electrolytes, kidney and liver function tests)A head up tilt test would be necessary to exclude possible orthostatic hypotension. If all these tests result normal there is nothing to worry about. Meanwhile, I would recommend avoiding prolonged standing up position and take plenty of fluids (water, juices) to stay well HY </s>

<s>[INST] my son was diagnosed with biliary atresia . when he was 2 weeks old, his bilirubin was high, cholic stools. doctors ordered intraoperative cholangiogram and they later found out his duct is fibrotic, so they took away his gallbladder and did another procedure, the Kasai procedure. Now, 2 weeks after operation his total bilirubin went down to 23 but his sgpt is still going up, 5 times the normal value. another 2 weeks passed, his total bilirubin is 12 but his sgpt is 241. what does this indicate?his sgpt keeps going up? his liver biopsy result when he had the operation is good. im concerned about the sgpt. if sgpt keeps going up, that means his liver is in the process of scarring? [/INST] Hi and welcome to Chat Doctor thanks for the query. Biliary amnesia is serious congenital anomaly and Kasai procedure is the only chance for them despite transplantation. Kasais procedure has high rate of complication, and it is not always successful. However these findings are still not alarming as this is expected after such surgeries and of course his liver won't function as it was healthy. Some elevation of LFT is expected, and he needs only frequent check up. Wish you good health. Regards </s>

<s>[INST] I m concerned about my brother. He talks to himself all the time and when I point it out he acts as if he was unaware. sometimes he is aware but i ll ask him why he said something and he insists that he didn t say it. I ve read that it can be a sign of high intelligence as it helps the brains thought process but the fact that he is more than usually unaware that he is even talking let alone what he said is troubling me more and more. He s also very irritable and he gets very angry. It s got worse as he s got older. He s 20 now. Any advice? Thanks x [/INST] Degree understand your concerns went through your details. I suggest you not to worry much. The self talking syn Chat Doctor. Preoccupation with a task always brings on such cosmetic difficulty. For others, it may seem strange, but the affected person is actually enjoying. Another mental health view point categorizes the behavior under schizophrenia. But I cannot see any relation here. So don't worry. If you need proper diagnosis, please consult a psychologist. 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] Patient is cronic case of AF. Is regular on anti coagulant and is taking acitrom from past more than 8 yrs . Due to recent gal bladder surgery/thereon internal bleeding etc and then fever for about more than week in last 3 months. Had 3 hospitalizations recently. lost more than 12 kg. All her recent test reports are normal. Feeling very weak and fatigued . can any health supplement /Tonic be given so that she gains strength, keeping in mind that she is on acitrom. [/INST] Hello. I have gone through your clinical details, you mentioned Tab Action for AF. But did not mention regarding doses and other medicines for AF and also did not mention etiology behind AF. Whatever You mentioned, It seems like your patient is suffering from some sepsis. Significant weight loss is a sign of some catabolism in the body related to infection or some other pathology. So first, you focus on to find out exact pathology behind weight loss. Because if we do not treat that pathology we can not stop weight loss whether you supplement some caloric foods or some tonics or not. So my advice for you to find out etiology behind significant weight loss and meanwhile you can supplement with high caloric diets like some Protein powders along with Iron supplements and some Multivitamins with Zinc. You also give some Diastase enzymes for proper digestion. </s>

<s>[INST] doctor i had pilonoidal sinus in my navel a while ago.....bt i got it treated(doctor removed all the hair inside and did the dressing)...it has been 3 months...now rescently i have felt that when i press my navel sown....i feel pain in the right side inside my navel.....is it related to my previous problem...or is it just a pimple...? [/INST] Hi. Thanks for your query. Noted the history of a true colonial sinus of the belly button / naval region, removal of the hair 3 months back. Now there is a pain on the right side of the naval on pressing.; wants to know whether this is related to the previous problem or just a simple pimple. As per the history you have provided, this looks to be the remnant of the previous problem. Colonial sinuses are known to recurrence after some time. I would advise you the following:Get a physical examination done and confirm by high resolution ultrasonography. IF the sinus is still there, you will require to have a re-exploration of the area and removed surgically for a permanent cure. MRI Sonography can help. Till then apply liquid provide iodine locally, take an antibiotic a </s>

<s>[INST] Male 38 has chest pain left side sometime suttle sometimes very painful, under stress mother just passed away two month ago. Is it just stress realated. Sometimes lasts a couple of days but then weeks pass and nothing. its mor noticeable when aggrivated or stressed out [/INST] Hello Left sided chest pain may be due to many causes like cardio-pulmonary causes. Other causes may be due to stress, muculoskeletal causes etc. It is always safe to exclude cardio-pulmonary causes in chest pain. You may need proper clinical examination and few investigations. Investigations include routine hologram, random blood sugar, liver function test, lipid profile, urine RE/ME, chest X-ray (PA view), ultrasound of abdomen, ECG,TMT, ECHO. Proper treatment depend upon findings. Get well soon. Take Care Chat Doctor. </s>

<s>[INST] I had routine lab work done in nov and my troponin level was 6.1. A week ago I had lab work again and the level was 9.5. I have a Thallium stress test scheduled for the end of the week. Needless to say I am quiet anxious about the test. I have not had chest pains. [/INST] Hello, Brief answer: Troponin level may vary according to acute heart insult also from lab to lab. Sometimes false positive troponin present. Explanation: My opinion is that troponin level is used to diagnose acute coronary syn Chat Doctor. Chest pain and dynamic or ischemic changes in EGC are an indication to measure troponin. So, it is not any time investigation such as CBC. Positive troponin points to myocardial injury, so anti-ischemic measurements should be initiated. Sometimes false positive troponin presents with renal failure for example. Also, variation in lab results may be an error in lab procedures. In your case, having no past history of chest pain makes diagnosis of ischemic heart is far-fetched. I suggest my patients the following if positive troponin. Do an EGC, echocardiogram and if those suggest myocardial ischemia, anti-ischemic measures are initiated on spot. The information provided by you is not sufficient to provide a good opinion. If someone comes to me with this condition I would ask them about other risk factors to develop ischemic heart disease, smoking, obesity, family history, etc. Also ask about diabetes as in diabetics silent ischemia happens (that means without chest pain). Conclusion: I suggest you do your thallium study as soon as possible to see if any ischemia develops in your heart and so treat accordingly. Hope I have answered your query. Let me know if I can assist you further. </s>

<s>[INST] My 70 yr old husband had diarrhea with 104.7 temp, lack of appetite, very dehydrated but no abd pain. CT showed collapsed gallbladder . He was on cipro for (chronic) ear infection 1 day when this began. Stool culture showed no c diff or salmonella but a blood culture was positive for gram + rods after 3 days. He is now on flagyll, lomotil, and sulpha antibiotic for ear infection. A gallbladder test is scheduled in 2 days. He continues to have fatigue and low grade fever on day 7. Blood culture repeated yesterday. Is this related to the gallbladder? Are we moving too slowly? [/INST] Hi welcome to Chat Doctor forum. Dear miss, Positive blood culture is a serious finding. And first thing to do is broad spectra antibiotic treatment, intravenous if possible. Second thing to do is to find the source of infection, it can be intra-abdominal but also urinary or lung infections too. So you should focus on these 3. When the source is found and the right cause identified then more accurate antibiotic can be used. Wish you good health. </s>

<s>[INST] My pcp checked me for hernia last week then referred me to a surgeon. I had hernia surgery 2yrs ago, where the surgeon used mesh to repair the hernia. My pain is on the same side as my first hernia. The surgeon checked me today and felt there was no hernia, and ordered a ct scan in avfew days. He seemed concerned though with my pain and its location. The pain is directly over my first surgery site, its deep and aching and travels down in my right testicle. I feel very nevous about what it could be, if its not hernia. Are there any concerns of a mass or tumor or cancer? Is that why he ordered a ct scan? Also Ive had 2 spinal fusions L4-S1 and a spinal stimulator implant in the last 3yrs. Any chance this issue could be related to my back issue? Im 33yrs old... My apologies for all questions, but Im concerned this is something more serious than what I thought... [/INST] Hello, Applying olive oil to the affected area of the leg. Olive oil is one of the best natural moisturizers which will instantly make the skin smoother and HY Chat Doctor. The small itchy and bumpy red spots that cause skin rash on legs can also be treated by using another natural source for skin diseases i.e. Aloe vera. The gel from aloe vera is very beneficial for restoring the skin to its normalcy and natural shine along with curing the rashes. It is also helpful as it kills the bacteria in the skin rash that might aggravate the problem further. Aloe Vera gel also HY </s>

<s>[INST] I am 17 years old and have had a reoccurring knee injury every year throughout my softball season. Normally it takes all summer to heal which isn t a big deal, however I am leaving for the Airforce in August so therefore don t have time to stop exercising and let it heal. It retains water under the kneecap. Also it is terrible pain trying to stand out of a crouched position and walking upstairs. I was told it was jumpers knee however symptoms of this seem to be the opposite of what I have. Normally it hurts going downstairs with jumpers not up like it does me. Also it hurts to run. Which is a necessity to be able to train! So is it jumpers knee or not? Also what should I do treatment wise if I don t have time to stop and rest? [/INST] Hi, thank-you for providing the brief history of you thorough musculoskeletal assessment is advised.Also, the pain is limiting your functional ability of climbing stairs and also from crouched position to stand up. If your physician mentioned a jumpers knee, I will advise to take an MRI scan of the knee as for me, it appears to be a more of a ligament sprain in the knee joint. But only with thorough musculoskeletal assessment and MRI scan the diagnosis can be made. With proper exercises and Rehabilitation program you can have a better knee, and you can join air force as well. RegardsJay In Chat Doctor. </s>

<s>[INST] Hi Dr.Sjjknk, first of all I am not a runner and I have not fallen, I have pain on the outer part of my ankle like if I did fall and sprain it but truly I did not. I am worried, what could be wrong I can walk to a certain extent and I m in pain when I do walk. [/INST] Hihope this msg finds u in good health. I have gone through your complaints and understand your concern. U seem to have some sort of nerve inflammation causing pain in that region. U need to get a X-ray done to find out what's wrong. U can take analgesics and anti-inflammatory tablets. Hot fomentation. Crepe. Nothing to worry about. Hope your question has been answered. If u have any follow-up queries, feel free to consult me anytime. Thanks Take care god bless </s>

<s>[INST] Hi, I am experiencing severe muscle pain two days after a fairly benign workout (about 10 minutes of lunges and squats using just bodyweight). I ve worked out much harder in the past, with heavy weights and not experienced anything like this. I can hardly walk, sit, or stand. My quads are even painful to the touch. Coincidentally, I have also developed a bumpy reddish rash on one side of my neck and later inside the opposite wrist. Cannot think of any new food or contact that might be causing it. Thanks [/INST] Hello, As per what I feel the muscle pain is due to DOES, which is called the delayed onset of muscle soreness. Which is common most times when one has done an exercise after a long time. This particular DOES takes 2-3 days of time to wean off as it's a soreness in the fibers of the muscle. You can do hot water fermentation and the pain will come down little which will help you perform ADL. Rest assured DOES don't last more than 2-3 days. Continue exercise but at a slow pace. Hope I have answered your query. Let me know if I can assist you further. Jay In Chat Doctor. </s>

<s>[INST] Hi - Yesterday I visited my GP with a marble-sized lump that has developed within the past week or so under the skin in my inner thigh. It s very firm, and a bit irregular in shape -- basically ovoid but with a little protrusion on top that seems attached to the skin. The remainder of the lump sits below the skin but does not appear to be embedded in the muscle. My doc basically ruled out a cyst or folliculitis (sp?), and seemed concerned by how fast it had appeared and the fact that it seemed rather firm/hard. He s referred me to a surgeon for further evaluation early next week. My questions are: (1) what are the possible causes; and (2) what questions should I be armed with when I see the surgeon next week? Thanks [/INST] HI ! Good afternoon. I am Chat Doctor answering your query. The possible causes could be from a benign lesion like a sebaceous cyst to a malignant lesion unless ruled out by a biopsy. When you see your surgeon next week, he is going to ask you the duration of the lesion, if any pain or trauma associated with it, any feeling of bump anywhere else in your body. He would then do a clinical examination of the swelling to confirm its physical characteristics, and might advise you for either a FNAC (fine needle aspiration cytology) or an excision biopsy for a hist pathological study after some routine blood tests. Further management would depend largely on the biopsy report. 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 ve been to Disneyland this week, and for five days i ve been riding roller coasters, nonstop. I ve always liked roller coasters, and to be honest I didn t ride any for a long time until now. Thing is, I feel so dizzy. I can sleep normally, I have no vomit urges or headaches , I just feel dizzy, like I have no sense of balance whatsoever. I only felt nausea today after dinner (Today was the last day on the resort and i also flew to my country).I ve been reading about head traumas and such, and now i feel really paranoid. Do i nedd to feel worried about this? [/INST] DearWelcome to ChatDoctorWe understand your concerns went through your problem description and suggest you not to worry excessively. You start doing your normal day-to-day activities at your hometown and everything should be alright. Such dizziness, nausea etc. after an extended episode of roller coaster ride and being at resort. There are several reasons. Roller coaster, food, water, sleep patterns, being tired day after day, feeling away from home and friends, etc., etc. Hope this clears your doubts. Available for further clarifications. Good luck. </s>

<s>[INST] hello Drs!! i just noticed 1 red spot on my top palate and next to it there is another one coming. I am really stressed atm due to exams but I would like some guidance! thank you very much! (4 days now i am on a pure protein diet-i dont know if this is important) thank you! [/INST] Thanks for your query, I have gone through your query. The red spot could be because of the ulcers like ah thous ulcer or herpetic ulcer. Consult an oral physician and get it ruled out. The authors ulcer can come secondary to stress. So do not take tension. If it is authors ulcer you can take topical anesthetic and analgesics like Anabel gel. Apply 3-4 times daily before food and topical steroid like triamcinolone acetone 0.1% 4-5times daily after food. Do saline gargling. If the lesion does not heal in 5-7 days then consult an oral physician and get it examined. I hope my answer will help you, take care. </s>

<s>[INST] Hi, I am XXXX from XXXX. Recently i had suffered from indigestion & stomach pain issue and visited a medicine specialist. He has prescribed me with Azithromycin 500mg (1+0+1) 7 days dose. now my problem has subside its been 04 days i am taking this drug. but when i take it i feel weakness, Headaches etc. what should i do now. [/INST] Hello, The symptoms are probably related to side effects of Azithromycin. I suggest using a Castro protector such as Omeprazole 20 mg in the morning before breakfast. I also suggest eating a healthy diet and Chat Doctor. Furthermore, I recommend taking a vitamin supplement, vitamin B12 to help with the weakness. In case of headache you can use Tylenol for relief. Hope I have answered your query. Let me know if I can assist you further. Take care </s>

<s>[INST] I have little small lumps all over my body underneath the skin. They are not painful however I notice that they are spreading more than ever. I have had this for about 5 or 6 years now and it is concerning, a dermatologist told me they were calcium deposits but I am begging to differ. I had one in the center of my chest that just formed a head and began to ooz puss out of it. Help PLease!! [/INST] Dear friend, You have multiple small lumps all over body and one lump at your chest. As per your description both condition are different. A multiple lump all over body since 5-6 years most likely a lipoma. Multiple subcutaneous lipoma is common condition and doesn't need any treatment until few of them going to be painful. A chest swelling with pus discharge may be either simple abscess or an infected sebaceous cyst. It needs antibiotics and surgical Chat Doctor. Thank You. Get Well Soon. </s>

<s>[INST] Hi I have had a sore throat type of thing for two weeks, It hurts to swallow I went to the doctor because at first I thought I had mono because my friend has it, I didnt share any food or drinks with her so the doctor said I was fine to just gargle with salt water and take Motrin, thats what Ive been doing its not helping at all, and my wisdom teeth are coming in so that hurts really bad I have tiny white spots around my top wisdom tooth on the right side. I also have red spots on the roof of my mouth all the way in the back. I cant open my jaw all the way it hurts and I feel like I have a bruise on my jawline, I want to get my wisdom teeth pulled because they hurt really bad what should I do and what is wrong with me? [/INST] Thanks for using Chat Doctor. Read your query. The symptoms described suggests an abscess in relation to the erupting third molar. I would advise you to continue the Motrin and warm saline gargling. Visit your local dentist and get it a radiograph done for its position and get removed if necessary. You will also need antibiotic including amoxicillin and metro lag (if you are not allergic to any medicine.) Antibiotics can be started with the prescription from your dentist. Keep the area clean with proper brushing. Hope this was useful. Thanks and regards. </s>

<s>[INST] Hello, I am curious about a condition my mother has. She has been having severe coughing fits, to the point where she becomes red from the force of the coughing. She tells me that the coughing is brought on by a tightness/burning feeling that originates from her throat and then travels down to her chest area. She says that this tightness/burning feeling can be brought on from a variety of factors: from simply breathing in to drinking cold liquids. Also, she says that these irritations and coughing episodes have produced clear phlegm. Can you possibly advise us as to what this condition may be? Thank you. [/INST] Thanks for your question on Chat Doctor. I can understand your concern. Severe persistent cough is commonly seen with lung infection and bronchitis. So better to take her to pulmonologist and get done clinical examination of respiratory system, chest x-ray and PFT (Pulmonary Function Test). Chest x-ray is needed to rule out lung infection. Put is must for the diagnosis of bronchitis. She will need antibiotics, inhaled bronchodilators and inhaled corticosteroid (ICS) based on above reports.Don't worry, she will be alright with all these. Hope I have solved your query. I will be happy to help you further. Wishing good health to your mother. Thanks. </s>

<s>[INST] Hi. My niece had an appendix surgery last Mon (April 1). The appendix was bad and near rupture when the surgery happened. Two days later she started getting a low grade fever which would sometimes rise to 101 or 102 degrees centigrade. She has been hospitalised again. There was water in the lining of her lungs which has been drained out. Fever persists twice a day. Doctors has some preliminary diagnosis of pneumonia or TB but both have now been ruled out. No conclusive diagnosis yet, any suggestions [/INST] Hi welcome to Chat Doctor forum. Thanks for choosing Chat Doctor. Forum. Your niece, got operated for appendicitis, on April 1st, still she is getting low grade fever. There was water in the lining of the lungs. It is called pleural effusion, and suggests tuberculosis infection. I advise you to consult a chest physician for diagnosis and treatment. You may have to get the fluid in the lining of the lungs tested after pleurocentisis, besides other routine tests for confirmation. The pain of the right lower abdomen also could be due to tuberculosis of the iliocaecal junction, that is to be operated and biopsy done, for confirmation. Wishing for a quick recovery. Best regards. </s>

<s>[INST] Sometimes I get a single bump either above or below my belt line. It starts off as a red bump then general looking like a zit. I will take a warm wash cloth ot it to release what is in side and it is a mixture of blood and puss. How do I rid myself of this [/INST] Hi, Dear,Good Evening from INDIA. Thanks for the query to Chat Doctor. I went through all the details of your query. On the details given by your query, In my opinion you suffer mostly from-on the facts there in-mostly you suffer from-furunclitis with infected pubic hair follicle. Treatment suggested would be-a-Tab NSAIDs x 5 days b-Cold compressesc-Antibiotics if you need be consult ER doctor for the script of Chat Doctor. Hope this would resolve your query. Welcome for any more query to Chat Doctor and ME, in this regard. Wishing you fast recovery. Write review ASAP with strong recommendations for Chat Doctor and for ME, for the benefit of other new and old patients. Have A Good Day. With </s>

<s>[INST] ANXIETY OR SOMETHING MORE?Ok for as long as i remember ive had problems with things being close to my eyes and glares. Even my eye doctor visits are torture. Here over the last couple years and more recently Ive been having episodes while im driving. Im fine if my windshield is clean but the moment i get a speck of mud,bug or even rain within my field of view i start having issues with keeping focused and if i have the wipers going holy crap its really hard to concentrate. Night driving has been getting a little harder because of this and the headlights of oncoming traffic make it almost impossible.Eventually i work my way thru it but it seems to be getting worse. What should I do? I cant find anything online that resembles my issues. Is it just anxiety? What makes things worse is im considering Lasik which i think is mentally driving me crazy.Physically i want/need it done but mentally just thinking of a person that close to my eyes makes me sick. personally I think im screwed. I dont know what to do and i dont want to look like a psycho to my Lasik doctor who i meet in a week for the first time. HELP! [/INST] Degree understand your concerns went through your details. I suggest you not to worry much. I can understand your problem. In my opinion this is not anxiety. In psychology, we broadly call it obsession. You had that disturbing sensation once. You expected it to happen again and tried. Then you started experiencing it as you were expecting it. Then your body brought the familiar symptom because you are expecting it. Then you started worrying that the symptom is coming again and again and expect it. Body brings it again as you are expecting it. You become worried and so on. That is obsession in simple terms. Ignore it and the problem vanishes. Though the basic problem is obsession, you are anxious about your obsession. In that case, you need counseling and if need be psychotherapy. Consult a psychologist. 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] Good day, my brother has his SGPT levels checked and he was advised to take ursofalk 250mg cap twice a day. however, his SGPT hasnt been normalized since then. I would like to inquire if there is a chance to normalize his SGPT again in a few months even without taking any liver medications? Thanks. [/INST] Hi thanks for asking question. You have not mentioned cause for elevated Sept ... It will be jaundiced by viral hepatitis mostly as you have given this tablet. Viral marker done. If you have hepatitis A or hepatitis E then no need for worry. Within few days mostly you will recover and Sept will normalize. But if you have hepatitis b or c then after few days repeat viral marker study done. Because there are more chance of chronic hepatitis as compare to hepatitis A or E. If you are carrier or chronic case of hepatitis then Sept will not come down. Heart problems can also lead elevated Sept. So rule out it... Take low fat diet. More fruits. Green leafy veg. Exercise done. If obstructive jaundice present then correction might be needed for obstructive cause like for ex. Gall stone. So rather than Chat Doctor. Take care. </s>

<s>[INST] OligospermiaHello.. Dr. My name is parag. My wife is not haveing a pregnancy After three year of marriege. I ask with my family dr. He advice me for test 1. male infertility test 2. seminal fluid examination. test result is my FSH Level : Folicular Stimulating Hormorne : 4.23 and My Sperm count is 1.0 million/ml Motility Active 20% Remark : Severe Oligospermia. I want medicine for increase my sperm count. [/INST] HelloThanks for your query, based on the facts that you have posted it appears that you have severe Oligospermia. Truly speaking there are so many Chat Doctor. Following measure will help you to boost up your confidence and help to increase sperm count to some extent.1) Practice regular exercise for 45 minutes followed by meditation for 1/2 an hour in the morning.2) Take high protein diet rich in vegetables and fruits and vitamin A, C,D, E.and Zinc3)Take anti oxidants like Almonds 5-6 every day.4) Avoid alcohol and smoking. </s>

<s>[INST] Sir,My Toxoplasma IGg Level presently is >200 and Cytomegalo virus IGg is about 176.4. Doctor prescribed me to take Rovamycine fortee. Also I am taking Metformin tableta for PCOD. Can i take both medicines together ? How long to wait for next pregnency? [/INST] HelloThanks for writing to us with your health concern. The IG G level DOES NOT MATTER. It just indicates past infection with the agent. In fact, it means that you have acquired good immunity, and do not require any medication for the same. Ig M means that there is recent infection, and if the IG M is positive, then that indicates that treatment is required. There is no need in your case to take Kanamycin Forte, unless IG M levels also are raised. If the IG M levels are normal, then there is no need to wait for planning a pregnancy.IN fact take daily folic acid tablets if planning for a baby. All the best. </s>

<s>[INST] Hello, my 11month old has had a constant runny nose for the past week. It starts out really green in the morning but runs clear by end of day. Because we ve constantly been wiping her nose, she developed small red bumps around her nostrils. The bumps have spread to the rest of her face, but mostly concentrated to where the mucus could ve spread after wiping her nose. Should I be concerned about these bumps? Also, should I be concerned about how long she has had this runny nose? It had affected her appetite, but as of yesterday that seems to be getting a little better. [/INST] Hi Dear, Welcome to Chat Doctor. Understanding your concern. As per your query your child have symptoms of infection in the nose which could be due to rhinitis(allergic or nonallergic), nasal polyp, left over upper respiratory tract or sinus infection. Need not worry. I would suggest you to not touch it again and again. Wash it properly, apply cold compresses and leave it like this for sometimes. Do not use any cream on it without prescription. I would suggest you to clean it with Betadine, consult dermatologist for proper examination. Doctor may prescribe antibiotics (clindamycin)along with vitamin C supplement for quick healing. You should take nasal saline rinses. Hope your concern has been resolved. Get Well Soon. Best Wishes, </s>

<s>[INST] I have been detected jaundice before 15 days and my Bilirubin serum was 5 and SGPT was found to be 600.Yesterday I had a blood test in which SGPT was found to be 100 and boilirubin serum was reduced to 2. I have to join the hostel from 16 th august 2011 and my diet is surely going to be disturbed. Will it be suitable to take the hostel food??? [/INST] Hi, dairy have gone through your question. I can understand your concern. You have jaundice with high Sept level. It is improving but still you should take of your diet. Because diet is the main treatment of it. You should take high protein and low fat diet. So you should avoid hostel food for few days. Once your liver came back to functioning properly then you can take it. So take of your diet for fee days. 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 male sharpei who is about 14 years old has a very strange rash growing on his back legs. it not necessarily near the genitals. the rash is on both back legs and spreads down to his feet . it is black and scabby. feels like leather and has been spreading, slowly at first but now more rapid. it is not on his belly, but is now slowing appearing on his front legs as well. what is this and how can i treat it? [/INST] Hi, Your sharpie would be having either allergic or irritant contact dermatitis. Or it would be some chronic relapsing disease like lichen plans or psoriasis. For actual diagnosis, he should consult to dermatologist. After complete diagnosis, proper treatment may be given. Local steroids with antibiotic cream may be encountered. Oral steroids in tampering dose may be helpful. Avoidance of contact with dust, soap, grass.etc. may be helpful. I hope you got my answer. Thanks. </s>

<s>[INST] Hi I just had a CT scan, have not talked to Dr. yet but nurse informed me results show I have a angiomylipoma in my right kidney and he is referring me to a urologist. My question is... what does this mean, what is it? and is there anything I should be doing in the mean time before I get into the specialist? [/INST] Hello and welcome to Chat Doctor. As a Urologist, let me advise you, that AML(angiomyolipoma), is not cancer. This is almost diagnostic on the ACTIVE, with typical features.There are three approaches to its management.1. Needle biopsy of the tumor, to confirm, it's an AML. If AML, leave it alone.2. Surgery, send the tumor for a biopsy. If AML, nothing more to do.3. Observation with regular CT scans, at 6-12 monthly intervals. Surgery, only if any changes noted. So, Ct alone isn't conclusive. If you've any doubt, send it to me, as a direct question, for expert opinion. Chat Doctor. Manga. </s>

<s>[INST] Hi, I moved house about 2 months ago which has a large garden and I have spent at least an hour each day pruning in addition to doing some painting. The last week I have been getting pins and needles sensation in my hands which is worst in the morning after sleep, my hand can also be completely numb when waking. What is happening/what is the problem other than over working the muscles? Can I do anything to help stop or ease it other than resting hands? [/INST] Hello, What I understand with the symptoms is they are neuropathic in nature. Here are the two possibilities which I feel on a provisional basis. Once it could be carpal tunnel syn Chat Doctor. Having checked by an orthopedist should provide some insights to the history in a more precise manner as it needs a physical examination. Since human hand has 3 different nerve supplying the hand muscles for different functions we need to assess that first. Also, the nerve has the role of motor and sensory functions. Out of which the numbness tingling pain is one of the function under a sensory system of the nerve. Any disturbances to the nerve may alter the functions and aggravate the symptoms. For now, I would say start basic static neck exercises which you can find online and also dipping the hand in hot water up to the mid-forearm, so the wrist is completely inside the water and perform wrist flexion and extension. Why this two exercise is because if the nerve is getting trapped in the neck region the neck exercises should help release the pressure and why hot water is to reduce the tightness over the flexor retinaculum, so the nerve trapping can get released. Hope I have answered your query. Let me know if I can assist you further. Jay In </s>

<s>[INST] I ve had regular periods since I started when I was 13- they usually last roughly 3 days. I have been on the Contraceptive Pill , Levlen ED for almost a year and things have run smoothly all year with next to no complications. Over New Years, I missed 3 pills, as I was away and forgot to pack them. I had my period on the 4th of this month for the normal amount of time. I continued to take my pill as per usual.. But being on the beige pills (not the sugar pills) after I d finished my menstrual cycle, I had bleeding almost two weeks later- last Sunday. This frightened me, I ve searched and searched for answers. Five days later and it s still going heavier than usual. So not only has my period come over being on the contraceptive pill which should usually stop it from coming at all if I decide to skip it- but it has lasted longer than usual, it has been much, much heavier, and for the first time since I started having my period, I have had really awful cramps to the point where I end up in tears . Is there something I can do- or is there something wrong with me? [/INST] Hi and thanks for the query, it is not unusual to experience abnormal bleeding while using pills or hormones. It might be important however to note that this could be incidental bleeding, implantation bleeding or at times, but in very rare occasions, a pregnancy. I suggest you should be calm. However, if case this persists, It might be prudent to undertake a pregnancy test. It is however too early to think of it, but it is a rare possibility. Kind regards </s>

<s>[INST] hi dr, I have 2 and half yrs baby.. by 8th month we came to know she has Jouberts syndrome... She has delayed milestones.. she started walking independently in 2 yrs by giving therapy.. now she speaks more than 30 words.. Her knowledge is good... Drs told there is 25% chance for her sibblings.. Is there any genetic testing for Jouberts? During pregnancy can we detect this.. if so by how many months? can u pls suggest a best scanning centre in chennai... Dr pls send me a valuable reply for this question.. [/INST] Hello, There is possible genetic testing for Joubert syn Chat Doctor. However, the diagnosis during pregnancy is achieved by ultrasound and MRI of the fetus in suspected cases. Gene testing requires a highly specialized genetic center, ultrasound and MRI are available in different centers including obstetrics-gynecology hospitals. Hope I have answered your query. Let me know if I can assist you further. </s>

<s>[INST] Hi, I am a 14 year old girl. Over the past year, I ve been feeling extremely depressed. I use to self harm every single night, I ve tried committing suicide but couldn t go through with it. I use to thoroughly enjoy playing sports, because it was one thing I was good at. However, over the last few weeks I barely have the enegry to turn up to a game. My attendance at school has dropped dramatically, my grades have dropped with them aswell. I am known as an unreliable employee because I rarely turn up to work. I ve just woken up at 2.00pm, I fell asleep at 11pm. I seem to just sleep my days away, my weight as increased dramatically also. I ve been told I abuse the use of alcohol and drugs, but have never seen it until now. I m just looking for a hand, a little bit of advice would be nice. thank you. [/INST] Degree understand your concerns went through your details. I suggest you not to worry much. There could be several factors combined. First you should visit a physician and get your thyroid checked for T4, T5 and TSH. If you find there is no problem with thyroid, then you must add Chat Doctor. Though you are just 14, there could be wasting diseases such as anemia. You also could be disappointed. Work with your physician for correct diagnosis. Don't diagnose self, please. 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] Five days ago I have a heart catherization done and they put in a stent cause I had 95% blockage. Since I came home from the hospital there has been an increased amount of bruising and well as a burning pain in the groin area all the way up to my rib area. I also have bruising of my testicles and penis. I have a hard time being on my feet for very long. I am a 54 year old male. Should I be seeking medical attention? [/INST] Respected sir, If there is local pain and increased bruising, both of which has increased post discharge, I humbly request you to inform your cardiology as there may be a local hematoma (blood clot) or pseudo aneurysm, which are known complications of femoral artery puncture(leg artery), used to assess the heart artery to put stent. Many a time they are managed conservatively so no need to worry in that context, but because you are on blood thinner, do inform your cardiologist </s>

<s>[INST] for the last couple of years ive been getting extremely light-headed sometimes with black spots flickering over my eyes. also my limbs sometimes go numb and give out. especially my legs. I also get extreme abdominal pain regularly. also have chest pains sometimes. help? my doctors wont listen. [/INST] Hi. Thanks for your query and an elucidated history. Your problem is for a long time-couple of years, and you are getting light-headed with blackening, limbs going numb and extreme pain in abdomen. Your problem may be due to severe form of colitis, wherein you get deficiencies of many vitamins, minerals and trace elements. I would advise you to go for colonoscopy and CT scan of the abdomen in addition to the routine blood, urine and stool test. The proper diagnosis, its treatment and symptomatic treatment for your symptoms with therapeutic dosages of multivitamins, minerals and trace elements would give you the best possible results. </s>

<s>[INST] In 2005 I was hospitalized for Pneumonia in which it was discovered that the top 1/4 of both my lungs and surrounding arties are burnt. The Doctor that treated me never said how, why. Years earlier I operated 4 laser marking equipment was told the equipment met OSHA requirements and no protection was needed I don t know if that is the reason that my lungs and arties are brittle. Now I m required to be on oxygen 24 hours a day.I want to know if the laser equipment might have caused the bad lungs?Thank youHelen McDaniel [/INST] No laser will cause these burnt out lungs. Burnt out lungs is a very vague and loose term used by some doctors, which means that the upper part of your lung is destroyed or not useful. There may be innumerable reasons for that destruction for instance, the commonsense are TuberculosisInterstitial lung diseased and bulbous lung disease Kindly let us know a proper history of your lifestyle, allergies, smoking and the CT scan findings </s>

<s>[INST] I have severe pain when putting pressure on left leg. Can not walk w/out assistance due to the severe pain. Hurt in my left buttocks / hip. I felt a day ago like I had pulled a muscle but now it s so severe all I can do is cry. Not so painful while sitting even though I feel it. 55 yr old female. [/INST] Hi, You have not directly mentioned, but it seems that this pain is acute (less than 24 hours) and has occurred after a strain to a muscle (I suggest in the future you clearly mention when the problem began). - A pain in the buttock and hip which is worsens by pressure could be due to the local inflammation or tightness of that area. The origin can be the muscles (in most cases), tendons, joint capsules or the joints themselves. As you mention that you cannot walk without assistance, the damage is significant. Please check the area and see if there are any bruises, swelling or local warmness/redness. If there are, you should refer to an orthopedist or ER to have x-rays and a detailed exam. -If you do not detect any of the above things, and it is less than 48 hours since the symptoms, you can use ice massage every 3-4 hours for 5 minutes. Do not apply the ice directly on the area, rap the ice in something and use its cooling effect indirectly. In the first step and the first 2-3 days, use acetaminophen to reduce pain. You can add other medication such as ibuprofen or diclofenac and change ice massage to hot massage after the 3rd day. If the pain is high enough after 3 days that makes you use assistance to walk, you have to refer to an orthopedist even if you do not see the above signs (swelling, redness, warmness, fever, local bruise). Hope I have answered your query. Let me know if I can assist you further. </s>

<s>[INST] I woke up last night with my heart racing. I was breathing slowly to calm my heart, but it kepts pumping extremely quickly. My depth perception is off and earlier my vision was blurry. I was shaking through all of this. Dad says its an anxiety attack. [/INST] Hello, This can be anxiety attack but will not wake you up from the sleep, I am keeping it lower down. This can be arrhythmia like PSV or atrial fibrillation, where your heart rate suddenly goes up and BP falls. These are episodic tachycardia and your ECG may be normal if you are not having tachycardia during ECG. You will need evaluation like thyroid test and holder monitoring. You should also get one hemoglobin levels done. So visit nearby cardiologist for this investigation. Also, to abort such episodes you should try to cough hard. Is there any stress or anxiety associated. Till the time your evaluation is complete, you can ask your local doctor for tab collar LA 20 mg once a day. If none of the above is successful then last option is of electrophysiologist studies which is invasive test which can diagnose and treat the arrhythmia permanently in most of the cases. Hope I have answered your query. Let me know if I can assist you further. </s>

<s>[INST] Hello Doctor,my son is 2 and 1/2 yrs old. This Jan we went to india when we came back to germany he joined a play group..since then he is having cough at times it s less at times it is cronic he was treated with antibiotics twice..anti mucous3-4 times for bronchitis once but it never goes away completely..it always revives dry cough with running nose a at times and his nose gets block when he sleeps....what is the cause please help we are really worried is it some kind of allergy...initially we thought it s because he is coming in contact with other children that may be a cause but there is no break. [/INST] Is their any family history of allergies in the family ? Has your son ever shown symptoms of allergic cough in the past? Since he is now in a play group and in contact with other child Chat Doctor. A blood work up with an X-ray chest will be helpful to rule out bacterial infections. If there is no evidence of an infective pathology, an anti-allergic orally with nasal cortisone spray at bedtime should relieve the symptoms. </s>

<s>[INST] hi.. Ive been waking up with blood in my mouth for the past year or so. And it only happens when Im sleeping. I would go to bed normal and wake up with a mouthful of blood every time i sleep. due to this, Ive lost weight, keep getting constant headaches and feeling weak all the time. [/INST] Thanks for your query, I have gone through your query. The bleeding for oral cavity could be because of the gum infection. It causes bleeding during morning time because during nighttime there will be any salivary function. The weight loss and headache could not be because of this. For the gum infection, you have to get your teeth cleaned, you can also use topical gum astringents like stolen. For headache and weight loss consult a general physician. I hope my answer will help you, take care. </s>

<s>[INST] I fell down a flight of stairs 10 days ago and the pain in my tailbone is excruciating. It hurts all the time, but It brings me to tears to do any barely lifting, standing on one leg (dressing), sitting, standing or walking for prolonged periods of time. Ive tried ice/heat and ibuprofen. Ive also tried pain patches, but I have a bad rash from them. Is there anything else I can try? [/INST] HIT hank for asking to ChatDoctorI can understand your problem even slight hair line fracture could cause such pain and this could be long-lasting, and you have to be patience and need to increase your pain bearing capacity, this may take at least couple of week, meanwhile you can take the "Diclofenac" 50 mg sustain release tab. This will give excellent result, nothing to worry about this, have nice day. </s>

<s>[INST] hi,iam betty from kenya,38yr old,igot my first baby at age 16 thereafter i have not been able to get pregnant a gain,after an investion i was diagnosed with block tubes,i went for ivf procedure which failed that is a month a go,what do i do am so frustrated thank u [/INST] Hi, Sorry for your disappointment.IVF in the best hands has a success rate of only 40%,so, though it is a disappointing news, it's a failure that has to be accepted. But, repeated IVF can increase the cumulative chance of getting pregnant. I would like to know if good quality embryos were formed or not? How many embryos and on what day were they replaced in uterus? If good embryos were formed, and they have frozen a few of them you could go for a transfer of these embryos in the next cycle. If no embryos were frozen, I would advise you to go for another 2 cycles of IVF. It is very likely that you will succeed, as IVF in women with blocked tubes have a better success rate. Hope this helps. Regards </s>

<s>[INST] Hi my dentist put a gold filling in my top tooth about a year ago i kept gettin very bad pain i asked him 4 times to take it out and he refused n said use sesitive tooth pate which didnt help da pain in da filling has now gone but da gum above is now reddy purple lump its painful to touch [/INST] Hi! Welcome to Chat Doctor. I read your query. If the filling hurt you so much, I wonder why it wasn't taken out. It appears may be filling was quite deep and close to the pulp. Over the years it caused irritation to pulp and infection. Also, any overhanging filling can also impinge into gums. I suggest you to visit a dentist and get x-ray of tooth done. According to tooth condition and infection, it may need RCT or extraction. Get a prescription of antibiotics and painkiller from dentist and take it. Do warm saline rinses. Maintain oral hygiene. Take healthy diet, multivitamin and mineral tablet one per day. Avoid spicy and acidic foods till treatment is over. Hope the answer helps you. Thank you! </s>

<s>[INST] Sir, i am a b.Tech student of final year. But due to mental stress(due to some unavoidable family problems and study pressure for getting a job), i am unable to concentrate on my study. And when i sit for study, within 5-10 minutes some unexpected topics come to my mind and i start discussing very seriously myself like a group discussion.i saw Aamir khan s satyamev jayate show on this topic and i got conclusion that it is curable by taking drugs. Please give me any solution so that i can concentrate on my study for my career. [/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. Meditation and yoga helps in improving concentration. Also, you need to have a good sleep and participate in aerobic exercises. The place of your work/study should be cozy and comfortable with good lighting. Hope I am able to answer your concerns. If you have any further query, I would be glad to help you. In future if you wish to contact me directly, you can use the below-mentioned link:bit.ly/ Chat Doctor. </s>

<s>[INST] My son(33 yrs) had some blood work done and his iron level was 194. He has a hematologist for essential thrombocythemia, who he saw yesterday, as his liver test showed ALT(94) and AST(51) which was down from the prior blood work done a week before. His hematologist said not to worry about the liver tests but I wasn t sure about the iron. I also was wondering if the hematologist was looking at the liver info re only cancer since that is his specialty too. Should any of this be of a concern? [/INST] Hi, dairy son has essential thrombocytopenia. It is myeloproliferative disease. He needs treatment for that. Don't worry about iron level and slightly high liver enzymes level. It is not a matter of concern. He should take aspirin to prevent any clotting. Chemotherapy is useful. Permanent treatment of choice is bone marrow transplantation. Consult your doctor and 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] Hi,We are trying to have a baby since last 7-8 months but no success. Done Semen test and stats are as follows:Volume : 2.5 mlTotal Count: 25 Million/mlMobility:Active: 25Sluggish: 15Non Motile: 60Morphology:Normal: 60Anbormal: 40Doctor has prescribed me LYCOMEGA twice a day.Contents of LYCOMEGA are as follows.Each softgelatin capsule contains : Omega 3 Marine Triglycerides 500 mg Containing EPA 90 mg + DHA 60 mg, Ubidecarenone (Co Enzyme Q10) 10 mg, Lycopene 15 mg, Green Tea Extract eq. to Polyphenols 150 mg, Beta Carotene 10 mg, Calcium Ascorbate 50 mg, Refind Wheat Germ Oil 25 mg, Zinc 27.45 mg, Selenium 70 mcgCan healthy sperm count can be increased? Please suggest. [/INST] Hi, I have gone through your query. Your semen analysis report is towards lower side with in normal range. This is causing difficulty in conceiving. Usually in these cases, antioxidant is prescribed such a Omega. This helps in decreasing abnormal sperm count which can be due to various environmental factors and habits. I suggest you to continue with Omega. Carnitine has also showed promising effects in improving sperm quality, that's why I recommend Tab carnivore to my patients. Do consider positive feedback as a credit to my work. Let me know if you have any further questions. </s>

<s>[INST] I have a curiosity question. I just had a CT scan and was told I have nodules in my lungs. Is there an easy explanation as to what that means? I just had PE s in both lungs which are now dissolved. No mention of nodules were made prior to the current CT. WOndering what causes them. t [/INST] Thanks for your question on Chat Doctor. Since you had pulmonary embolism with new developing nodules on CT thorax, we need to rule out following possibilities.1. Connective tissue diseases (CTD)2. Malignancy3. Tuberculosis4. Acidosis. So better to consult pulmonologist and get done bronchoscopy and BAD (Bronchoalveolar Lavage) analysis to rule out above-mentioned causes. If everything is normal then get done repeat scan after 6 months to see whether nodules are increasing, static or decreasing in size. </s>

<s>[INST] Hi, my son is 16 months old. He is very cheerful in nature in general. But when we want to eat him something solid he does not want to eat and starts to cry and resist. It is very difficult for us to feed him as he is not at all interest to eat anything. What will be the remedy to increase his appetite ? [/INST] Hi dear Welcome to the Chat Doctor, His appetite is good, but he is not well-trained for chewing. He does not want to exert in chewing, he just wants to suck only (which is quite easy for him) and he is quite tuned to it. We have to take the lot of pains for training of this child. Repeated frequent small feed to be tired like DAL rice, mashed banana.etc. so that he can develop the taste of such eatables. Try to reduce the bottle-feed/ milk. Hope the query is answered. Thanks </s>

<s>[INST] I am a 32 year old male suffering from constant wheezing / asthama since 10 years and i am on a dose of seretide 125 mg daily . For four years I worked in the middle east(saudi arabia) and i never had an attack nor was there a need for inhalers.I have asked this question to a couple of doctors but the only answer i get is that you stay near the coastline in and more over in an indian metropolitan city with high levels of pollutions.This has always puzzled me since even in the middle east i stayed near the coast line with frequent dust storms . What might be the actual reason? [/INST] NOBODY CAN TELL YOU EXACT CAUSE NOT EVEN YOU CAN JUDGE WITH IMAGINATION SIT CAN BE ANYTHING ALLERGY CAN START AT ANY TIME WITH ANY SUBSTANCE AT ANY ANGELOU CAN GO FOR ALLERGY TESTS ONLY TO FIND OTHER ARE COMBINATION F MANY ALLERGENS WHICChatDoctorE AFTER TESTATOR FOODS YOU HAVE TO ELIMINATE THEM FROM DIET AND FOR DUSTS AND POLLEN YOU CAN HAVE Desensitization THERAPY TO CURE ALLERGIES MUST TELL YOU THAT ON COSTAL AREAS THERE ARE DUST MITES WHICH ARE MAJOR CAUSE OF ALLERGIES IN WORD </s>

<s>[INST] My father is 78 and had a triple bypass last Wednesday. They put a balloon pump in on Tuesday to help his heart. He came out of the surgery fine and his vitals are good, but he isnt coherent, sleeps constantly and wont eat. He doesnt seem to know that Im there. Concerned [/INST] Hello! Welcome on Chat Doctor! I carefully passed through your question and would explain that your fathers symptoms could be related to different possible causes: - prolonged effects of anesthesia-possible stroke-confusion or delirium after surgery. That is why I would recommend consulting with a neurologist for a careful physical exam. A brain CT scan may be needed to exclude possible stroke. Hope to have been helpful! Kind regards, </s>

<s>[INST] yes i have realy sore knots or should say lumps on my feet one is on my heal so sore i cant touch it the other is on the other foot on the bottom next to the side in the center of my foot i cant even rest my feet on the flore they hurt so bad what it wrong with my feet [/INST] Hi, dairy have gone through your question. I can understand your concern. You may have some corn or wart like lesion. You should go for excision biopsy and histopathological examination. Then take further treatment if needed. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using Chat Doctor. Wish you a very good health. </s>

<s>[INST] Yellow Stools, Under Right Rib Pain, i had my gallbladder remove a year ago and now i have this problem, is not all the time, i think is when i eat to greasy food. I have a little esophagus hernia, gastritis and reflux and usually when i have the symptoms above i usually vomit like acid fluid and get a headache. At the ER the took an X ray of the area and found nothing. Still want to know if this is normal after the gallbladder surgery and it is go away? [/INST] Hi and welcome to Chat Doctor. Thank you for your query. It can be normal as a part of postcholecystectomy syn Chat Doctor. Sometime more than a year should pass till your digestion stabilize again. You should have more frequent but smaller meals and avoid alcohol, fats and smoking. Also follow some hepatoprotective diets and check frequently your liver enzymes. This can also be gastritis so it doesn't need to be related to gallbladder removal. Wish you good health. </s>

<s>[INST] Hi, I am a goth and have always been a little jealous of others in my subculture who have the flawless, very pale skin (without makeup) all over their whole body. Are there any natural remedies that I can try at home to lighten my skin a few shades? Ive been trying to find some online and have come across several, but I need help separating things that will work and things that could potentially be harmful. Some of them were lemon juice and papaya masks. Could you help me please? [/INST] **1. It could be genetic, so Initially do visit a dermatologist/cosmetologist, prior to any alternate system of medicine.2. Stay away from the sun during peak hours [11 AM to 4 PM] or ensure a good sunscreen applied on the area to limit damages.3. Sandal wood powder pack (rejuvenates skin)Ingredients:-sandal wood powder, turmeric powder, milk Method of preparation:-mix all the ingredients to form a paste. Apply this as face pack.4. Tomato juice is one of the best natural home remedy which has been used for years. The enzymes and acid in tomatoes have lightening qualities like lemons.PS. Take a proper guidance and follow up with a good dermatologist, get your vitamin B12 level checked, as its deficiency can cause darkening of skin. . To get proper result, you are suggested to use any face pack or cream for 3 to 4 months. </s>

<s>[INST] age 68 years sex male tlc count 54000(getting reduce from last two days earlier it was 65000) current status : he is on ventilator at present. diagnosis chronic kidney disease stage5 urosepsis hypertension type II diabetes mellitus prostatic abscess pyonephrosis post dj stenting [/INST] Hi Greetings from Chat Doctor He is a patient of CKD (chronic kidney disease). TLC is very low that indicates his body immune power is very low. The CKD result from DM and Hypertension. There is also an abscess in prostate and also infection in kidney. He may be in septicemia condition now. He is under ventilator as you are telling. So prognosis is not so good. Wishing for a rapid cure. Thank you for contacting us </s>

<s>[INST] They found a 1cm by 2cm spot on my pancreas during a routine CAT scan that I have done every 6 months, to see if my liver cirrhosis turned cancer...liver was clear, but this spot has me very concerned. My G.I. ordered an Ultra sound with fasting for the 9th of June. In your opinion what are the odds it is cancer and if not what else could it be. [/INST] Thanks for your question on Chat Doctor. Liver cirrhosis is a precancerous condition for HCC (Hepatic Cell Carcinoma). So if in CAT scan liver is clearer than no need to worry about liver malignancy. But you should investigate further for spots on pancreas. This can be calcified nodule or enlarged lymph node or infective loci. Better to rule out these by endoscopic ultrasound. So consult GI doctor and get done endoscopic ultrasound. </s>

<s>[INST] hi i am 28/female/married. its 7 yrs passed bt i didnt get concievd, so me and my husband had our routine check ups regarding this nd we got to kno the problem which is vry low sprem count, its about 8million. from last 3 years we are getting our treatment for ths bt it does not help us. recently i have done my laproscopy nd my all reports are as perfect as it should be.. so plz doc help me out for this life disheartening prob. should i go for icsi coz i ve done iui for 2 times bt that also does not help us... and if u r also agree for icsi then plz let me know the best doc or hospital for ths in delhi or ncr.. [/INST] Hi welcome to Chat Doctor. I have gone through your question. Low sperm count 8million/ml is very low. I would advise doing ultrasound color Doppler scan for scrotum to find the reason for low sperm count, varicocele, vascularity of testes. If you couldn't get success through GUI then can go for CSI (intracytoplasmic sperm injection) IVF (invited fertilization). In Delhi and NCR there are so many hospitals like aims etc. Hope I answered it question. Would be happy to help you further. Take care. </s>

<s>[INST] good morning had unprotected sex, and my boyfriend injaculated inside me. we had sex about 8pm sunday night and i took the first dose at 12:27 pm wednesday. i fell asleep and forgot to take the second dose. when i woke up it was 3:43 am on thursday morning when i took the second. i want to know if i will still become pregnant [/INST] Hello, Since you have missed the 72-hour protective window, you may not be protected by the pills. If you happen to be during your fertile period when the intercourse happened, you have very good chance of conception. You may have some amount of with Chat Doctor. Please wait for your next natural period and get expert help in person if you do not see it even after ten days after it is due. Hope you find this information useful. Wish you good health. </s>

<s>[INST] I had anti rabies vaccination in November. Yesterday while feeding a stray pup got needle like prick sensation in my finger by the pups teeth . There was absolutely no bleeding and no pain at all except the prick. Do I have to take vaccination again? [/INST] Hi and Welcome to Chat Doctor. I appreciate your concern for the dogs teeth prick. Since you have already received anti rabies vaccines last November, you need to take two booster doses of Anti rabies vaccine on days 0 and 3. Even though there was no bleeding or pain at all, but the fact that the saliva of the biting animal contains the sufficient amount of rabies virus, so you need to have protection again. Hope this answers your query. </s>

<s>[INST] Just recently, I started getting this flutter in my chest. It will happen maybe once or twice a week and it feels like theres a butterfly in my chest flying around. I can t tell if it s my heart or upper airway. It creates this feeling in my throat that I have to cough. This all happens in about 5 seconds and then its gone. i was adopted so i don t know if this is due to a family history of heart problems. I am only 20 years old. [/INST] Thanks for your question on Chat Doctor. Fluttering feeling in chest represents mostly palpitations. So we need to rule out cardiac cause first, as in young persons' arrhythmia s are more common. So get done ECG first. If this is normal go for holder monitoring (continuous recording of ECG). If this is also normal than no need to worry about heart disease. Other causes for palpitations are1. Anemia2. Thyroid problems3. Stress AMD anxiety. So better to get done CBC to rule out anemia. Get done thyroid level to rule out thyroid related problems. If all of the above are normal, then no need to worry much. . Anxiety may be the cause. </s>

<s>[INST] Hi, I am a 66 year old female and suffer from high blood pressure. However I am not feeling well, have been violently sick and feel as if my heart is missing a beat. My blood pressure is 120 over 62 and pulse 77. I had a total knee replacement 4 weeks ago and have a lot of swelling in the knee and leg. Is this normal please. [/INST] Hello! Welcome and thank you for asking on Chat Doctor! Regarding your concern, I would explain that your blood pressure and heart rate values are within the normal ranges. Regarding your symptoms, they could be related to inflammation. I recommend consulting with your attending physician for a careful physical exam and some tests: - a resting ECG and cardiac ultrasound to examine your cardiac structure and function- an ambulatory 24-48 hours ECG monitoring to examine your heart rhythm trends during the day and exclude possible cardiac arrhythmia-blood lab tests (complete blood count, PCR, sedimentation rate, blood electrolytes, thyroid hormone levels). You should discuss with your doctor on the above tests. Hope you will find this answer helpful! Greetings! </s>

<s>[INST] Hi doctor, i am a 41 year old female, i weigh 9stone which is about right for my height.I live in Greece and i get a yeast infection atleast once a month. I am taking a 200mg capsule of lomexin...fenticonazole nitrate and i use verdal cream...my husband uses the verdal cream too [/INST] Hi, Welcome to Chat Doctor! I understand your query. Well there are several causes of recurrent infections. Primarily, your immune status may not be up to mark i.e. you might be having some immune deficiency. Ensure a proper balanced diet with good eggs and non-veg intake if you are a non-vegetarian, as they are a rich source of proteins. Soybean is also a rich source of proteins. You might want to get investigated to find out the cause of this immune deficiency. Another common cause of recurrent infections is Diabetes. I'd strongly advice you to get a fasting and post radial blood glucose test done to find out your diabetes status. Thirdly, are you sure it's a yeast infection? I'd suggest you to visit a gynecologist and get it examined to rule out any other condition. Hope this information helps. Feel free to ask if to have any doubt. Wishing you a speedy recovery. With warm regards, </s>

<s>[INST] Hi I am in Malawi and was sleeping without a mosquito net last night. I woke up with over a hundred bites on my legs. I was wearing long sleeved top and a skirt when sleeping, and the bites are only on my legs. What I think is strange is that they are not itching and they have a white ring around them. The bites are red and are slightly raised from the skin. Are these really mosquito bites, or can it be something else and I should go see a doctor? Terese [/INST] Hi welcome to Chat Doctor, I understand your query and concern. Your symptoms are suggestive of hypersensitivity reaction secondary to itch of insect bite. I advise you to get skin hypersensitivity test. I also advise you to start taking Chat Doctor. Levocet, Tab. Fexofenadine and tab.flucon for 5 days. If symptoms do not relieve within 3 days, you need to go to an Emergency room and monitor your vitalsConsult your physician and dermatologist for expert management. Hope I have answered your query at the moment. Post your further queries if any, Thank you. </s>

<s>[INST] My daughter is 8 years old. About two weeks ago she fainted. We called 911 and then we took her to the ER where they checked her blood pressure, did an EKG and checked her blood sugar. All tests came back good. However, she continues to have dizzy spells. The spells are usually short but sometimes she is tired after having them. Any ideas what this could be? [/INST] Dizziness in child Chat Doctor. As your children EKG is normal she is unlikely to have heart problems. She might be suffering from neurological problems like an epilepsy. An electroencephalogram may be helpful in the diagnosis of epilepsy. Your child will need to take a detailed history such as whether she is suffering from nausea, vomiting and lose consciousness during an episode of dizziness. Dizziness can also be due to simply benign paroxysmal vertigo, a fairly harmless childhood disorder. It may be also due to nervous system diseases like multiple sclerosis. Hence, dizziness in child cannot be ignored. Your child needs some more investigations. I suggest that you should consult a neurologist immediately. </s>

<s>[INST] Hello sir i am 29 years old currently in bangalore , i am in love with a girl(whom i am about to marry in couple of months)we had sex 3- 5 times and i couldn t last for more than 1 minute, she is not satisfied that i can see that even she says she is ok, i have read many articles of premature ejaculation symptoms are the same. I am about to marry her but i am in a feeling where i may not make her happy. Is there a way where i can get out of this. And i am very shy kind of person to discuss this with others or donno how to approach anyone with this. Please suggest. [/INST] Hello, Anxiety is the main problem for premature ejaculation. Also, check for sugar levels and testosterone levels. Avoid alcohol and smoking. Eat green leafy vegetables helpful. After erection intermittent intercourse with squeezing, the technique may useful. Need counseling by sex therapist and psychiatrist helpful. Chat Doctor. Please consult your sex therapist for further evaluation and treatment. Hope I have answered your query. Let me know if I can assist you further. </s>

<s>[INST] hi im suffering from pocs and want to concieve.Is any chance to concieve during these months im using tab clomimd twice a day for five days and tab.duphaston thrice a day for 10 days and now im using this month LEZRA FOR 5 days and after 17 days using duphaston thrice a day for 10 days plz do advise me [/INST] Hi welcome to Chat Doctor. I have gone through your question. Pcod (polycystic ovarian disease) is the condition where so small follicles develop but not single follicle develop up to the mark that can rupture. So closed and Ezra are prescribed to increase follicle size and duphastone a progestin to make uterine wall favorable for implantation. With pod one can conceive, no need to worry about that. Hope I have answered your query. Would be happy to help you further. Take care. </s>

<s>[INST] My 3 year old just had an episode that began with her legs shaking in a way that scared her and made her dad pick her up. She then got very weak or dizzy (not sure which one because she couldnt explain it) to the point that she couldnt hold herself up. I noticed that her yes were moving very rapidly from side to side. This all lasted about 6 minutes. She then just became very hot, sweaty, and pink in the cheeks and said she was too tired to walk and needed to be held. It took over 30 minutes for her to completely come back around to herself she was so exhausted. This is the 3rd dizzy spell she has had in 6 months but the first time I noticed the eyes. What is going on? Is this a seizure? [/INST] HIT hank for asking to ChatDoctorI can understand your concern, this is not the seizure, this type of behavior changes are common in the pediatric age group, and nothing to worry about this because this does not cause any harm neither this is indication of any disease, but if this symptom persists for longer than enough time then the child should be examined clinically, hope this information helps you, have nice day. </s>

<s>[INST] My 3-year old has excessive sweating during sleeping. This does not disturb her, she sleeps well. I am afraid she d catch a cold sleeping in all wet PJ s in a dump bed for 10 hours (keep changing her PJs and sheets all night). should I be worried? and what can I do to make her sweat less? [/INST] Hi, Any other symptoms like exercise intolerance (while playing/running)? Is she gaining weight normally? Excessive sweating present only during sleeping is unlikely related to any disease, especially if she does not have any other symptoms and is gaining weight normally. Try wearing loose and minimal clothes at night(preferably cotton), and if using air conditioner, make room temperature at 25-28 deg. Take care. Hope I have answered your question. Let me know if I can assist you further. </s>

<s>[INST] hi,iam 23 years old..i have been doing (gym) heavy weight exercises since two months.three days back i incresaed the weights in the gym for doing exercises as usual,one more thing i started aerobics also since 5 days.So three days back i did my aerobic and then gym and after that within 15 minutes i took power horse,then after coming home almost after an hour took bath and i boiled eggs in which by mistake too much salt felt.so i thought the egg shell would prevent it from penetrating in the egg.gradually after two hours my heart heart started beating fast and its been three days i havent seen any change..its still beating fast.i went to the docter,the docter told me that its 159 BP ..i was so shocked.she said no need to worry but just dring as much as water as i can...please docs here .please guide me.what should i do..should i take steam bath and swimming or should i go to gym for removing the access salts in body....please suggest me [/INST] The information regarding your readings is incomplete. I am not sure whether 159 is your pulse rate or blood pressure (BP). In either case, I would suggest you to be retained your calmness. A single ingestion of high dose salt does not cause any harm in most of the cases. Your body does have a mechanism to get rid of excess salt. Please follow the instructions given by your consultant. Chat Doctor. Have a regular blood pressure and pulse rate measurements till you are normal. Stay calm and relaxed buddy. You will be normal in a few days. Hope the above information helps. </s>

<s>[INST] URINALYSIS , COMPLETE Test Within Range Out of Range Biological Ref Range Units COLOR PALE YELLOW LIGHT YELLOW - DARK YELLOW APPEARANCE SLIGHTLY CLOUDY H CLEAR SPECIFIC GRAVITY 1.010 1.005 - 1.030 PH 5.5 5.0 - 8.0 GLUCOSE NEGATIVE NEGATIVE BILIRUBIN NEGATIVE NEGATIVE KETONES NEGATIVE NEGATIVE OCCULT BLOOD TRACE H NEGATIVE PROTEIN NEGATIVE NEGATIVE NITRITE NEGATIVE NEGATIVE LEUKOCYTE ESTERASE 3+ H NEGATIVE WBC 20-40 H NONE SEEN - 5 /HPF RBC 0-3 NONE SEEN - 3 /HPF SQUAMOUS EPITHELIAL CELLS 0-5 NONE SEEN - 5 /HPF TRANSITIONAL EPITHELIAL CELLS NONE SEEN NONE SEEN - 5 /HPF RENAL EPITHELIAL CELLS NONE SEEN NONE SEEN - 3 /HPF BACTERIA NONE SEEN NONE SEEN /HPF CALCIUM OXALATE CRYSTALS NONE SEEN NONE SEEN - FEW /HPF TRIPLE PHOSPHATE CRYSTALS NONE SEEN NONE SEEN - FEW /HPF URIC ACID CRYSTALS NONE SEEN NONE SEEN - FEW /HPF AMORPHOUS SEDIMENT NONE SEEN NONE SEEN - FEW /HPF CRYSTALS NONE SEEN NONE SEEN /HPF HYALINE CAST NONE SEEN NONE SEEN /LPF GRANULAR CAST NONE SEEN NONE SEEN /LPF CASTS NONE SEEN /LPF YEAST NONE SEEN NONE SEEN /HPF **Panel Comments** URINALYSIS, COMPLETE plz suggest [/INST] ``Hello and thanks posting your query on ChatDoctorYour urinalysis report indicates that there is presence of pus cells and epithelial cells in urine. Levels of leukocyte esterase is raised in urine which indicates presence of esterase positive bacteria in urine. You should get a urine culture done and start antibiotics according to the culture report. Rest of the findings are within normal limits. Thanks and take care </s>

<s>[INST] My daughter is 4 months old and she has a branchial cyst on her neck. It doesn t bother her and it s not infected, but it seeps clear liquid off and on. It s very small and there s no lump, but I m wondering if it would be best to get it removed now or later for her sake? [/INST] Hello, It can be an infected bronchial cyst or some other entity known as bronchial fistula. Surgical removal of the lesion will be the best option. Consult a pediatric surgeon, and he will direct you accordingly. You can wait till the infection settles and antibiotics may be required for the time being. Usually we can wait up to fourteen years of age, and in some cases the lesion will resolve by it own. Hope I have answered your query. Let me know if I can assist you further. Take care </s>

<s>[INST] Hi,I am 25/M feeling terrible chest pain in addition to chrohns disease, high cholestrol,high BP Doctor diagnosed me to be of Vitamin D3 Deficient. Please suggest is this terrible chest pain is only due to Vitamin D3 deficiency(less than 4). Even I am being administered 60000IU / week for 6 months. I have taken 3 doses upto now but there is no relief in chest pain [/INST] Thanks for your question on Chat Doctor. I can understand your concern. No, vitamin D3 deficiency can not cause this kind of severe chest pain. Most common symptom of vitamin D 3 deficiencies is bilateral lower limb pain. And after 3 doses of vitamin D 3 you are still having chest pain, so in my opinion we should search for other cause for your chest pain. Better to get done ECG, 2d echo and chest x-ray. If all these are normal then no need to worry about heart or lung related diseases. Apply warm water pad on affected areas. Take simple painkiller and muscle relaxant Chat Doctor. Wear rib belt. Don't worry, you will be alright with all these. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. </s>

<s>[INST] i have noticed 2 lumps on either side of my neck for around 12 months now but forgot all about them until recently, the one on the right is getting bigger...more of a grape in size than a pea. I am a fit healthy 30 year old women, i run alot.I have no pain with the lumps. what could they be?My Granda died of throat cancer and never smoked a day in his life. I do not smoke but just a tad worried [/INST] Welcome to Chat Doctor. 1. The lumps in the neck on bilaterally suggests lymph nodal enlargement at first place followed by thyroid swelling. Followed by any glandular or lipomatous.2. Lymph nodal enlargement is seen in case of any infection / inflammation / malignancy and lymph nodal pathology itself (lymphadenopathy) 3. The diagnosis can be done with the help of an ultrasound neck, which helps to evaluate the nature of the lumps, its source and extensions.4. For definitive diagnosis - an FNAC - fine needle aspiration cytology will help to evaluate the type of cells involved.5. Sugget to get an appointment with your GP, examined, investigated and treated accordingly. Good luck. Hope I have answered your query,anything to ask ? Do not hesitate to ask.http://doctor.ChatDoctor .com/doctors/ Chat Doctor. </s>

<s>[INST] Yes my question is that I have my irregular periods n last I had my periods on 1 May till 15 may n then till now I have no periods so i am taking this syrup masturd from hamdard so can u tell me what should I do for my periods can come n then I can try for the baby thanku [/INST] Hello dairy understand your concernFirst you have to find the cause of irregular period. Your symptoms could be due to hormonal imbalance, polycystic ovary disease, endometriosis, adenomyosis, thyroid dysfunction. I would suggest consulting the gynecologist and undergo reproductive and thyroid hormone analysis, USG scan, ovarian follicle study to confirm the cause. Specific treatment will depend on the cause. Chat Doctor. Once your period become regular, you chance of become pregnant will increase. </s>

<s>[INST] Hi,Two years ago my father got stoke, and lose his temporary memory, Dr. advised to use marevan-5mg in evening with semva teb. in morning " loprin 75mg, with depricap cap"my question is;- how long he use the marevan and loprin teb.? although he lose his weight from 80kg 60kg.kindly advice to avoid the side effects of these medicines. Aamir [/INST] Hi Amir Khan, Thank you for posting your query. Marevan (warfarin) is an anticoagulant and Joplin (aspirin) is an antiplatelet. Both these Chat Doctor. Generally, these medications are required life-long, however, your doctor would help you more in this regard. The commonest side effects are bleeding-such as from nose, in urine, while passing stools, from gums while brushing teeth. If any of these occur, please discuss with your doctor. Please get back if you require any additional information. Best wishes, </s>

<s>[INST] Hi, so im coming to you because I really need some thoughts and opinions from you about my sexual reactions. It seems that everytime I ejaculate almost immediately after I start to get this feel and uneasy and I notice my body temperature rise, even through the next couple of day I notice sweat stains under my arm pit that I would not get if I have not ejaculated. These feelings typically last around 7-10 days, after that period I feel pretty normal. This is a problem that keeps me away from sexual activity since I want to avoid this occurrence. So what are your thoughts on this matter because I get the biggest feeling that this is not normal and something is wrong. Also to add, I have been diagnosed with Hepatitis B but it is not chronic or activity currently. Im a really fir individual who exercise on a regular basis and play University level soccer. It would be much appreciated if you reply and give me your thoughts on the problem may be. As you can imagine it is something i shy away from and its hard for me to talk about. Thanks. [/INST] Thanks for asking in Chat Doctor forum In short: Experiencing hot flushes and sweating after sex/ejaculation is completely normal phenomenon. As you are very active in sports I think your Basal metabolic rate might be more and might be experiencing feeling of rise in temperature for many days. I do not think your ejaculation and this problem is related. Please do visit a doctor and ask him to investigate you for hyperthyroidism /hypermetabolic states. Good luck </s>

<s>[INST] Age 60 years ,diabetic since 2003 but usually keep it under control with medicines and exercise except some short duration jump in glucose level. HbAIc level remains between 6.5 to 8.2. Since 2009 I have developed B.P and am taking Amdepin 5 for it.For the last 3 years I have developed cracks under the sole of my feet with hardening of skin around the cracks like rashes which are difficult to heal. There is no peeling of the skin.Some Doctors diagnosed it as dry eczema ,others fungus and some other as psoriasis. I took treatment for all these but with no permanent relief. I have used salicylic acid ointments but the cracks do not heal fully and re-appear after very short duration.I have noticed one particular phenomena. When the cracks are about to heal say around 90 % and if suddenly I have tension due to any reason even for a moment I feel as if my blood is boiling and feel strange and acute itching under the sole my feet and within few minutes there are cracks again. within next one or two days skin thickens around the cracks. Suppose I have arguments with any body for a minute, immediately there is itching under my feet and cracks appear thereafter. Cracks also aggravate whenever I have allergic cold . I am taking following tablets now a days for diabetes and H.T:-Morning dosages:1. Amdepin 52. Glimisave M 13. Aspisol 754. Nuromark5. Evion LCAt dinner:6. Piglit MF 15Note: For H.T I have tried Telmistar tab but that does not suit me and causes sudden unsteady gait for a second while taking morning walk. My father suffered from Psoriasis/lichen planus. He took treatment from different Hospitals and doctors like A.I.I.M.S, Irwin Hospital, Dr Ram Manohar Lohia Hospital, Behal Skin Institute and other Private practiotioners but with every treatment his condition deteriorated and ultimately he died of Skin Cancer in the year 1986 at the age of 57. Therefore I do not want to take any oral medicine especially averse to taking any Steroids.At present I am applying Xerina foot cream in the morning and at night. My diabetic physician has now prescribed the following drugs:1.To stop Evion LC and take Bio D3 Fem once daily and Tayo 60 K once in a week for 4 months2. Instead of Amdepin 5 to take Ramihart-53. To take Telekast-L once daily in the night.4. To stop Nuromark for one month and restart after that.Please advise. [/INST] Hi, welcome to Chat Doctor,first you need to be diagnosed properly, as different physician has diagnosed differently, fungal infection, psoriasis and Chat Doctor. Although clinical diagnosis is straight forward, but some times need diagnostic help to diagnose. Skin smear under KOH will show fungal hype in fungal infection. Psoriasis needs dermatopathological examination. If you can send us clinical photograph then it will be helpful. Psoriasis has no cure, it can only be controlled. Thanks </s>

<s>[INST] Hi. I am diagnosed with PCOS when I was 17. Now I am 28. For the past 10 years im just ignoring my pcos as im not really care about what it is. Just for the past a year, i started to do active research on it and seek for treatment as my menstrual cycle usually every 35 to 40 days. My gynae suggest YASMIN but in 1st cycle with it I encountered severe side effects such as bloated, stomach pain and breast tenderness. So i stop taking it. Last month i had my menses on 20/6/14 (bleeding) and ends exactly weeks after that. However on 2/7/14 i had back brownish kind of menses with clots till today (14/7/14). Is it something i should be worried about? And of course severe pain on right pelvic and back pain on and off. Am i having other problem than pcos such as endometriosis? Thanking you in advance. Regards. Aira [/INST] PCs and endometriosis management may have different procedures in modern science but in Ayurveda, treatment is 100% similar and effective in both the conditions. Try to get Pathway Swath liquid which is herbal decoction clearing endometrium on prolonged use. It clears cysts even by easing shedding out cysts also. Its pure herbal. No side effects. No interaction. May be used for six months also. Commonly available in India. Elsewhere, try to find it on net. It will help you 100%. I m 100% confident with my experience. </s>

<s>[INST] Sir, I am suffering from negative thinking from the last 12 years and taking treatment and consuming Fludac 20 mg daily . my main problem is that I am going to be promoted on higher job. the work of higher job is very hard and uninterest. my mind is not allowing to do the work. When I think about that work, I became upset and negative. I want to do the work but my mind is not allowing me. how can I make my mind to do that work. this is big problem. [/INST] Degree understand your concerns went through your details. The duty of your mind is to think. You cannot control your minds thinking. But certainly you can divert your thinking. You can make your mind to be always positive by engaging in creative activities, hobbies, games and being passionate towards whatever you do. Thereby you can reduce your stress and tension also. Once you can do this, loss of proper sleep and stress also can be made normal. From the given details, I think, it is not your job making you uninterested. It is your attitude towards your job. I believe, you don't like your job or the atmosphere. Being passionate towards your job is the key. You need to cultivate it. I suggest you psychological counseling to overcome the present problem. If you require more of my help in this aspect, please use this URL. http://goo.gl/aYW2pR. Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications. Good luck. Take care. </s>

<s>[INST] hi my name is tom. my age is 52, weight 180 lbs., ht 70 inches.i stay very active and consider myself in good shape. my question is. i have noticed lately that when i use my left hand to push or pull on a door knob or something similar, i get a tingling or a electrical shock of some degree.(on the area of my hand that is applying pressure) i have verified that there is nothing related to actual electrical shortages. its my body creating this continues shock feeling. Maybe i still have a little spark in me what s going on. some what concerned. [/INST] Hello, Based on your description of your complaints. What I can infer is that you may be suffering from left-hand tendinitis or spondylosis of cervical spine. In plain layman language tendinitis means when due to overuse or aging the tendons become inflamed. So whenever you use your hand repeatedly there is a tingling and uncomfortable sensation. In the second condition the nerves whicChatDoctore to your upper hand may be pinched in your neck causing the shock like sensation in your arm. Would recommend you to see an orthopedic specialist if the symptoms continue. Hope I have answered your query. Let me know if I can assist you further. Take care </s>

<s>[INST] HI my mom is suffering from multiple myeloma and undergoing treatment for the same.I just wanna ask about the importance of serum beta 2 microglobulin test and its importance in the disease mentioned above b coz inspite of others tests being normal ,this test always shows a higher value.please answer .I will be thankful to you. [/INST] Hi and thanks for the question. Beta 2 microglobuilin is a small protein associated with multiple myeloma. In course of this disease, some chains of particular antibodies, including Beta 2 micrglobulin are produced. The quantity or concentration of this substance in blood gives an indication of the stage of the disease, and measures the outcome or prognosis. The lower the concentrations of this substance, the better the outcome. It is therefore measured to know the stage of the disease and to monitor the evolution of the patient under treatment. Increasing values imply that the treatment is not very effective, whereas decreasing values implies the effectiveness, and good prognosis of the patient. It is actually a measure of the morbidity and the mortality of the disease. Thanks and hope this helps, Luchuo, MD. </s>

<s>[INST] My son developed small (looks like heat rash bumps) all over his body after rolling around in the snow. His Pediatrician gave him medicine #1 with steriod (I forget the name) it did nothing... then a stronger one with steriod, no improvement, now medicine by mouth WITH STERIOD... it is driving me crazy... what do you suggest? I plan to try Eucerin Calming body wash and Aveeno oatmeal... HELP me relieve my little man s itching... it pains me not to bring this to a close... [/INST] Hi, As per your query, your child has symptoms of itchy rashes which could be hives which can occur due to our environment, heat, cold, insect bite and sun exposure. It is the bodies' response to the trigger factor. The most important thing is to find the trigger factor. I would suggest you give cold compresses to hives several times a day to prevent from swelling and itching and take over the counter antihistamine Chat Doctor. </s>

<s>[INST] Hello- Can taking Vitamin B supplements stain your teeth? I started taking more B12 (1000 units a day) about a year ago and my dentist has noticed more staining on my teeth during cleanings. I also started using COQ10. We re trying to figure out (as my diet hasn t changed) what s causing the stains. Also, about a year ago, I started a new regiment for HIV---Triumeq (which consolidates three pills into one) so I m just trying to figure out how to stave off the stains per my dentist. Thank you! [/INST] Hi. Thanks for the query. The medication that you are taking are not seen to cause staining of teeth rather it can be due to causes like roughness of teeth with age, improper brushing technique, using mouthwash can also at times cause staining and the most common is poor oral hygiene maintenance.However, if you are taking any iron supplements then it can cause staining of teeth. Excess intake of tea and coffee, smoking etc. can cause staining of teeth. You should first learn a proper brushing technique from your dentist and go for regular dental cleaning that is every 6 months... Use a mixture of HY Chat Doctor. . Eat more of hard fruits as they have cleaning action on teeth and along with it </s>

<s>[INST] I have stage 4 cancer 2 years...undetermined primary...tumor on hip bone...now spread to ribs...heavy chemo 1/10...given 6 mos. now back (almost 18 mos.)... spread to rib (bones...secondary)...now chemo every 3 wks. for rest of life...on my 3rd round of 3 wks test now show high alt/sgpt and low albumin. what can i do to help high. Read I need to increase protein intake for high. What if anything I can do to lower high alt/sgpt? Every doctor I have seen says that they have never seen this before....some are quite enjoying specimun (me). Been to mant top cancer centers so I feel quite satisfied that we have correct diagnosis....undetermined. [/INST] HI Welcome to Chat Doctor Very sorry for your condition. See your SGPT/Alt is high because of two reasons. 1, Chemotherapy. 2. Could be a spread to Liver. Ask your Oncologist to either change the chemo regime or reduce the dose (if possible) as that might help your Alt levels. I also advise you to take Header 1 sachet every day for 1 month. This will bring down your SGPT levels. If you can post your reports I can help you better. </s>

<s>[INST] I just had a friend that fell off the roof of a camper (6-7 feet) and landed on a retaining wall. he was hurt. Took him to urgent Care and they said he probably has a rib that separated from the cartilage. The pain is left sided only (where he landed) and 3 fingers width from the Xyphoid process. What do we do? I am skeptical as he is in so much pain. He says he feels like marbles are inside his chest cavity [/INST] Hi, thank-you for providing the brief history of you. A thorough clinical Musculoskeletal assessment is advised along with an x-ray or CT scan. As the injury is on the ribs and three fingers away from the typhoid process a thorough understanding of the rib bone and muscles is required.Also, lungs had to be checked for any damage since there is discomfort in the chest. Taking a therapeutic ultrasound therapy will help reduce the inflammation and pain. Also, using the taping technique the rib movements can be restricted, and the pain can be lowered Followed by the healing, proper costal breathing exercise technique is applied to make sure the Strength in the muscle groups. Usually in my clinical practice patients respond to Therapeutic ultrasound therapy, taping and costal breathing exercises. RegardsJay In Chat Doctor. </s>

<s>[INST] Hi iam Rehaan. My wife is a lupus patient for past 12 years. Her kidneys are mild increase in cortical echoes. Her protein level is negative. Her creatinine level was well under control below 1.0. Only this month her bp was very high for some reasons 170/100 for a weeks time. Now after medication bp is under control. Now her creatinine level is 1.3. When the bp was high.the increase in the crtinine level was due to hypertension. Also her HB is 8.0 now. Pls suggest. Thank u [/INST] Hi, dairy have gone through your question. I can understand your concern. She has lupus. Hypertension is common with lupus. She should take medicine for hypertension. Don't worry about creatinine. Her hemoglobin is also low. Go for anemia profile and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using Chat Doctor. Wish you a very good health. </s>

<s>[INST] hi, I am 88, developed a rash, which is above the belly button, and felt like it might be Shingles....only it is not on just one side, sorta in center. Have a burning sensation. if not Shingles, what is this? Did get some Calamine to put on it. Thanks for your info. cp [/INST] Hello, It could be either psoriasis or seborrhea dermatitis. I don't think it is shingles. Shingles usually present in a stripe or band-like pattern on one side of the body. I suggest you take an oral antihistamine e.g. Cetirizine tablet once a day. In addition, I suggest you to apply a topical steroid e.g. either triamcinolone acetone or dexamethasone vale rate cream, twice daily. Hope I have answered your query. Let me know if I can assist you further. Take care Chat Doctor. , Dermatologist </s>

<s>[INST] I am suffering with a tremor on my left hand side this started in my leg and has progressed up the body and into my head over the last 18 months i also feel week worse at night time when i am still. I also get heart palputations and sometimes my heart beats much harder and feels as if it is out of rythm. I am 53 years old. [/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. Tremors on One side of the body can be due to 1. Cerebellar Problems 2. Basal ganglia Problems To Proceed Further you need to undergo 1. Clinical Examination 2. Radiological Evaluation Please consult a Neurosurgeon at the earliest 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. Best Wishes for Speedy Recovery Let me know if I can assist you further. Take care.-loops 1 : After all your doubts have been cleared, kindly (a) Close this Question (b) Rate my Replies and (c) Give your Feedback. PS 2 : 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] Hey can you please tell me any sure shot remedy for psoriasis . I have it all on my hairline and a part of my forhead is also covered with. I have a small patch on my eye which doesn t look as bad as the forhead one. Also, I have it n my ears, back on the nape of my neck and even on my cleavage. Can someone please tell me what to apply and do. I don t want to use any steriod creams as I am 22 and dont want to mess myself up. Thanks [/INST] Hello would be pleased to answer your question. There is no sure shot treatment for Psoriasis. Non-steroidal approaches to the treatment of psoriasis include Tacrolimus which should be applied on the areas involved. Tacrolimus is an anti-inflammatory which will help in reducing the inflammation. It is safe to be applied. Another applied creams include those which contain urea, moisturizing factors and Amy lac applications . Thanks and take care </s>

<s>[INST] I am 9 days post 3 day transfer icsi, I was taking gestone shots until day 7, taking lutinus peseries 3 times a day, I am getting night sweats and hot flashes a lot, is this normal? this is my 5th fresh transfer and never had this symptom but never took gestone shots before, I had 2 pregnancies but lost before 13 weeks. are these hot flashes a bad sign? [/INST] Hallow Dear, Gestone is a progesterone preparation. Furthermore you are using Lucius vaginal pessaries also, which again are progesterone. Progesterone is smooth muscle relaxant and thus relaxes even the blood vessels. Therefore, Chat Doctor. It is most likely that your blood pressure is getting lowered which causes hot flushes and sweating at night. Please take your Gynecologists opinion. If it is not alarming, please continue taking Gemstone and Lucius since Progesterone helps to stabilize the pregnancy. Since you are on CSI treatment, doctors are taking all the precautions to support your pregnancy and minimize the chances of any abortion. Your previous pregnancies were not supported by Gemstone, and they unfortunately ended in abortion. Therefore, this time the doctors have taken additional preventive precaution by giving Gemstone to prevent the possibility of abortion. I hope Gemstone and Lucius will work to stabilize your pregnancy, and you will have a bonny baby to breastfeed at the end of the term. </s>

<s>[INST] Hi I ve got a tightness in my chest and sometimes a bubbling sensation with it, my heart races and I feel like I m going to faint. I do suffer from panic attacks and have for years. I am not sure whether to be concerned or whether it is my anxiety. I have felt like this for about 4 days. I ve still done all my normal activities and I m not in pain just this burning sensation in the middle of my chest. Thx [/INST] Yellowest tightness with fast heart beat need proper evaluation. It may be due to coronary heart disease, reflux,psychogenic etc. You need proper clinical examination and investigations. Investigations include routine hologram, random blood sugar, thyroid profile, liver function test, renal function test, lipid profile, urine RE/ME, ultrasound of abdomen, TMT,ECG in all leads, ECHO. Proper treatment depend upon findings. Get well soon. Take Care Chat Doctor. </s>

<s>[INST] tooth 19 a molar - the endontist started a root canal but closed it after he looked in. he said the root is cracked and if i had the root canal the tooth would only last about 6 months. what can i do to save the tooth it is scheduled to be extracted. thanks dr. ginny [/INST] His, Welcome To Chat Doctor & Thanks For Asking Your Query Here I understand your concern that you want to save your tooth but its completely depends upon the condition of your tooth and surrounding bone and tissue It is almost not possible to save it if the root of your molar has a complete vertical fracture running from crown towards the tip of root but if fracture is little of incomplete than there are chances of post & core built up after completing Root canal a dental X-ray will show the exact pathology as your endodontist has suggested going for extraction, he would have definitely looked at all possible way to save the tooth but if you feel uncertain you can always take a second advise however if your tooth can not be saved with any possible treatment you may opt for a dental Implant which your Chat Doctor. </s>

<s>[INST] My father is 60 years old he lives with me,he woke up this morning with a large lump,the size of a orange cut in two on his right upper buttocks close to the belt line,it isnt painfull I can push on it put he says it doesnt hurt,in feels soft at the surface like it should but when pressed on I feel a semi hard lump,the only clue I have is that about a month ago he fell on that same buttock,bruised it X-ray came out fine and it healed now out of the blue this,Im stumped please help me decide what to do, sincerely Shannon [/INST] Hi ! Good morning. I am Chat Doctor answering your query. From the history of trauma, it seems that he developed a hematoma at that time, which did not resolve, and is in the way of getting organized. However, it can be firmly said only by a clinical examination. If I were your doctor, I would clinically examine him, stop all the blood thinning agents if he was on it after consulting his treating physician, go for a clotting profit and also advise a CT scan of the area if need be to be sure of the diagnosis before planning the management. 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] My kid has fever for past 8 day and was taking Azthiromycin for past five days .She developed lymph nodes in her neck after which doctor had asked us to start with Omnicef.She is taking omnicef for past 3 days.I see no difference. She gets fever after 12 hours of Ibugesic.Kindly help [/INST] Hi, Thank you for asking question on Chat Doctor. Any infection of the scalp will develop enlarged lymph nodes in the neck. Nonspecific infection, tuberculosis, leukemia and lymphomas may cause enlarged lymph nodes. Thorough investigation is needed to arrive at a diagnosis. Better consult pediatrician. Hope this answer will serve your purposeless feel free to ask any more queries if requiredTake care Chat Doctor. V. Subrahmanyam MD;Disassociate professor of pediatrics </s>