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<s>[INST] I have left flank pain, left rib pain, muscle knots in lef flank pulling one rib out of place, onset of headache/nausea today, increasing pain - had x-ray last week if upper back and left flank, some mild arthritis that I’m told doesn’t account for rib pain. Urine screen about three months ago, everything looked fine. Abdomen tender when examined by Dr. last week. Was sent for x-ray and to continue PT, f/u w/ PCP tomorrow night, worried about increasing pain, unsure if am should go to ED or wait til PCP appt tomorrow night. [/INST] Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. You can take Tramadol and paracetamol combination 2 times a day for five days take Omeprazole twice a day for five days take Cefixime twice a day for five days. Take rest. Don't bend your back. Take proper sleep, apply Diclofenac spray at pain site 2-3 times in a day apply warm water bag application at pain site 2-3 times in a day. Hope I have answered your query. Let me know if I can assist you further. </s>

<s>[INST] Hi doctor, I am 37 years old. I have mild pain in left testes and it hangs more than usual. This happens for the last four to five days. I feel discomfort during walking and mild pain in the lower abdomen just above the left testicle. Please help. [/INST] Hi. Hope you are doing well. Coming back to your query, I think you are having an infection in your left testis a condition known as Epididymo-orchitis. First, you have to give yourself scrotal support (a langot /relatively small V shaped underwear) to support your testes from hanging. Second, start medication as in the prescription (see attachment). Are you a diabetic? Do you have any urinary complaints (night frequency, burning micturation, poor stream)? Any previous history of accident, trauma, urinary catheterization? Are you on any medications? Are you a smoker or alcoholic? If you can click a photo of both testis then it will be great. Last the ultrasound you uploaded has photos (attachment removed to protect patient identity), if you can upload a picture of the report then it will be better. </s>

<s>[INST] My 3 year old has been complaining of back pain for the past 3 weeks. We have had her urine tested and blood work has come back normal. We were told it could be that she s constipated even though she poops 2-3 times a day. We started giving her miralax 3 days ago and she started drinking Pediasure with fiber. Is this all I can do at this point? How long before we might start seeing a change? [/INST] Hello,Did your child have any history of trauma? If yes get an mri spine done.Otherwise usg abdomen for evaluation of other abdominal pathologies. </s>

<s>[INST] Hi, I recently consumed MDMA crystals and by the way me and my friends felt can assume that it must have been cut with another chemical. I am fairly experienced with the usage of MDMA and infer this as the drug experience lasted in total about 14 hours, had terrible migraines and as bad an upset stomach. However after 1 or 2 days I started developing numb big toes but only the tops of them. It has been a week or so and am wondering what to do and if I should be worried. This is the first time this is happening and where I stay, India, it is not so easy to talk to a doctor about such matters. Any help is appreciated.Top [/INST] Hi and welcome to HCM.This can definitely be effect of MDMA and this is the first thing to think of. Your body tells you that you must stop using it immidiately or ti may have very serious consequances. Various other symptoms can be caused by these drugs and this is just the beginnng of it. Numbness may indicate neural disorder but also itcan be blood clotting in your peripheral vessels. You need to see doctor if your symptoms persist.Wish you good health.Regards </s>

<s>[INST] hi my name is Linda. 2 years ago i had open heart surgery where i was told of having Congestive Heart Failure.However for the past few days, my right shoulder has been hurting severely which made me stay up all night. So i was wondering if i have a frozen shoulder. [/INST] Hello,I read carefully your query and understand your concern. Your symptoms can be related to a frozen shoulder.I suggest using anti inflammatory medications such as Acetaminophen to relieve the pain. Physical therapy is the most common treatment for a frozen shoulder. So,if the symptoms continue, I also recommend physical therapy. Hope my answer was helpful.If you have further queries feel free to contact me again.Kind regards! Dr.Dorina Gurabardhi General &Family Physician </s>

<s>[INST] The last 2 weeks i've had pinpoint pains by on my chest. A couple that reoccur are a small pain by my left collar bone, by my left rib and a pinpoint pain on the right side of my chest. When I think about about I have shortened breaths and its scary. My arm doesn't get num but it just seems to be certain spots that have pain which feel like if you were to grab your finger and poke your face. Its not unbearable pain, but just a little nub so to say. I have no medical insurance and don't know what to do [/INST] Hello,I evaluated your query in detail. Age is the major factor to be considered in etiology missing here. According to the narration seems non-specific neurotic pain with more of the anxiety exacerbation of the issue due to underlying fear of heart problem. My suggestions for you at present: • Take simple analgesic as Tylenol as per dosage of age criteria• Deep breathing exercises with yoga are the main pillars of your management part • Avoid weight lifting/heavy workouts• Maintain hydration with plenty of liquids• Avoid smoking/alcohol if using• Avoid stress, anxiety• Have regular sound sleep of 7 to 8 hours • Consult your family doctor once for BP measurement and general evaluation if required he may order you x-ray chest if needed rather than scarringHope I have answered your query. Let me know if I can assist you further.Regards,Dr. Bhagyesh V. Patel </s>

<s>[INST] i had unprotected sex and took the morning after period. I had more unprotected sex after that, we were using the withdrawal method. At my estimated menstrual period time, i got all the symptoms-cramps, tender breasts, pimples etc but very little blood quite unusual as i usually have a very heavy flow. Could i be pregnant? [/INST] HiI can understand your concern for the delayed period following unprotected sex.Delayed period following unprotected sex and symptoms like cramps, breasts tenderness, pimples are suggestive of an early pregnancy.Withdrawal method is not an effective form of birth control. Sperms can enter the vagina if withdrawal isn not properly timed or if pre-ejaculation fluid contains sperm. Of every 100 women whose partners use withdrawal, 4 will become pregnant each year if they always do it correctly. Of every 100 women whose partners use withdrawal, 27 will become pregnant each year if they do not always do it correctly. Pregnancy is also possible if semen or pre-ejaculate is spilled on the vulva.So, I advise you to get the pregnancy test done on an early morning urine sample and consult a gynecologist.Hope this answers your query. </s>

<s>[INST] I have a kidney stone that is 2.7 cm in size. I have seen my urologist and he has given me 2 options. 1 to have the stone blasted in 2 separate procedures, or be hospitalized and have the stone removed through a small incision (a tube placed in the incision.) I know that the procedure through my back will allow them to remove all of the stone at one time, but I am concerned that I will have to be off of work for over 10 days. However I have read that there are side affects from the blasting technique as well. I don't know which procedure to do... [/INST] Dear Sir,Sorry to hear about your problem. Your stone is quite big and the blasting procedure would require multiple sittings to completely get rid of the stone. Such a big stone usually mandates a surgery although with the new blasting techniques these days doctors are able to deal with such stones as well. The blasting technique is associated with a small risk of pain during and after each procedure and a risk of infection but you do not require prolonged admission.On the other hand the surgical part will take care stone in one sitting but would require a lengthy admission.Hoping for the best. Please feel free to clarify any other query. </s>

<s>[INST] ive had pain in my ribs for a few months and recently had further tests done which show i have fluid on my lungs i also had a blood test which showed my ca125 levels were raised and have now been sent to see a specialist what is it they are considering? [/INST] Hello As you explain the history ca 125 os for tumors unfortunately however wait fo the specialist opinion Regards Dr.Jolanda </s>

<s>[INST] Hi doctor, I am a childless woman for the past six years after marriage. Recently, we went to an IVF center. All my reports and my partner's reports were normal. The doctor prescribed me medicines such as Letrozole, Metital, Supradyn, Folmet, and Meprate. I am confused about Meprate. I am maintaining a calendar to track my menstrual cycle so that intercourse during ovulation can increase the chances of pregnancy. How are Meprate and intercourse related? Please guide me. [/INST] Hi. Most of the medications given in the process of treatment help in having a regular menstrual cycle, regular ovulation, and to get rid of irregular periods and to support conception. Meprate is progestin. It will act as progesterone which reduces the overgrowth of endometrial thickness, and they help in ovulation. They are given in patients having irregular cycles. After ovulation, it helps in conception. For quitting the medications, you have to consult your treating doctor. Have folic acid regularly. </s>

<s>[INST] Generally feel unwell - though symptoms largely not specific as vary over time. Lat week had pain in left side of lower abdomen, today have nausea.Feel as though am constantly running a slight temperature and suffer with periods of hot sweats - both at night and during the day. Am well past the menopause at 63. Constant feeling of tiredness. Am diabetic and have under active thyroid. [/INST] Hello!My name is Dr. Aida and I am glad to attend you on Healthcaremagic!Your symptoms could be related to thyroid hormone imbalance or any other metabolic disorders (vitamin deficiency, electrolyte imbalance, etc.). An inflammatory disorder or a chronic infection can not be excluded either. Coming to this point, I would recommend consulting with your GP for a physical exam and some tests: - a chest X ray study- complete blood count for anemia- PCR and sedimentation rate for inflammation- an abdominal ultrasound- thyroid hormone levels- HbA1C (considering the fact that you are diabetic)- blood electrolytes. You should discuss with your doctor on the above tests. Hope you will find this answer helpful!Best wishes! </s>

<s>[INST] My husband has a sudden onset, painful, lump on the right side of his clavicle. He had an x-Ray and the doctor thought it was arthritis. He is a smoker x 30 years. Should he get a second opinion or take doctor s advice and wait to see if it goes down? [/INST] Hi,Thnks for the Query.1-I have studied your story indepth.2- I would advise you to have second opinion by a surgeon in your area.3-Mail the x-ray plate copy and the report-and I would advise a second opinion on it,4-AS its sudden onset-lump on the right sided clavicle,till the time second opinion on the lump and the x-ray report is taken-I would not advise any treatment plan in such case.5-Mostly it appears to be -infectious lump-on the clavicle -which needs to confirmed after the second opinion . or may be other wise-as told by your doctor....6-Right way is to go to surgeon and attend to it -with his advise....Hope I made it very clear about the treatment of painful lump on the clavicle-and its only by going to surgeon-as immediate treatment needs to be planned. Thnks.Wellcome for any more queries in this matter. </s>

<s>[INST] what if i take herbal medicine for acne and other problem though i m hypothyroid patient. Is it ok to take herbal medicine being a thyroid patient? please help. [/INST] hiii Welcome to HCM. As you are presents with hypothyroid,you should take Tab Eltroxin and dose depends on your biochemical value of TSH. Try herbal medicine for acne..may get good result. All the best. </s>

<s>[INST] Hi, my father underwent CABG on Dec 2. He started taking bath from Dec 8 after the surgeon advised so. It seemed then that his stitches had healed. Today we found a water like liquid coming out from where the upper end of the incision started. We observed that after he felt something there. Is it something to worry about? What should be the first aid? We are going to see the surgeon tomorrow.Thanks [/INST] Hello there,I am dr.milan an infectious disease specialist answering your question,This watery fluid coming is of two type either infection or noin-ifectious, inflammatory.If infection is there it cause associated symptoms like fever and bodyache etc. Sometimes it is inflammatory because there is cut has been made and presence of stitches cause local irritation cause serous(watery) fluid from there by inflammatory response of our body.You should go for culture examination of that watery fluid along with complete blood count to rule out infection.I advise you to maintain hygienic cleaning of wound and take rest along with healthy diet. Please Follow your surgeon's opinion.Hope i have given appropriate guidance to you.if you have any query you can consult me anytime.Give me star rating according to your satisfactory level.Thanking you. </s>

<s>[INST] I am professional Telecom Consultant and i had performed consultancy in different countries. Recently I was going to some country and a medical problem occured which name is Hepatitus B ( HBsAG ) which seems positive in my report rest i have throughly check with doctor and they told me its negative on your body and its not affecting you at all so no treatment required. But you are a carrier of this problem and it will show your report positive so because of this issue i am not able to get work permit in any middle east country and there is no medical way to get rid of this problem. help me to solve this issue. I would be very thank ful to you. [/INST] Hi welcome to HCMForum. it is better you consult a gastroenterologist for treatment. these days many medicines are discovered. besides i advise you some diet restrictions as Avoid fatty foods like fries, ghee, nonvegetarian dishes etc. eat the things rich in carbohydrtes like pilses, fruits & juices. besides i advise you to consult gastro enterologist of our paid channel ASK A DOCTOR NOW. wishing for an early recovery. </s>

<s>[INST] I had stomach pain in the lower right side of my abdomen that felt like contractions. I have had a complete hysterectomy so it is not pregnancy-related. The pain has subsided but my right side feels very tight and like I could have another cramp/contraction at any time. [/INST] The most common cause of right side lower abdominal pain is acute appendicitis.I would advise you to get ultrasound abdomen to rule out appendicitis. For cramps you can take any antispasmodic like Tab Meftalspas. </s>

<s>[INST] Hi It s my 5th month of pregnancy..Dr. told me that there is some issue in both kidney of my baby.. According to radialogist report both fetal kidney shows mild fullness and fetal bladder is empty..i am much worried.. plz tell what to do..whats the reason? [/INST] Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. While development of kidney, utters & bladder in fertal body development. The reading of full kidneys &empty bladder can be seem while the things are yetto fully matured. So one finding is not to be considered for final diagnosis. Repeated readings after some in feral are taken before such diagnosis is made. Many a times normality is found in subsequent readings. So be cool. In case the repeated readings have same findings. Certain specific tests are done before coming to final conclusion. So just be positive and follow your doctor's advise. Hope I have answered your query. Let me know if I can assist you further. </s>

<s>[INST] Hi, may I answer your health queries right now ? Please type your query here...I am having a terrible toothache and when I stand up or lie down, I can feel my pulse in my tooth. I can't stand this throbbing pain anymore but I can't afford a trip to the dentist. Any suggestions? [/INST] Dear User,Thanks for using health care magic.From the available description it appears that there is infection in root of your teeth. The another possibility is of caries tooth which leads to raw surface and this gives sense of pulsation if exposed to low or high temperature.Visiting dentist is required as he can only provide the suitable treatment for condition after diagnosing it.Other than keep your oral hygiene in better form so there is no or minimal risk of repeated infection.'Hope I have answered your query. If you have any further questions I will be happy to help".Thanks </s>

<s>[INST] Hi,im 31years old..trying for second baby ..one month delayed in periods..so I checked wit test card it showed faint line..den checked wit gynec she took scan n said 3unruptured eggs are der wait for 10more days..but after ten days I got bleeding but again the eggs are in same state wen I scanned today..doc said need to do laparoscopy...is it needed?guide me pls [/INST] yes its needed to have better view of the eggs ..because to know the condition of there rupture...laparoscopy is more accurate </s>

<s>[INST] i have a boil in my upper eye lid....its been over 10 days..i thought it will go away but it hasnt...during the first few days there was a little pain...now its painless..now i think it could be a chalazion...is there any way i can get rid of this without surgical treatment?? [/INST] Hi.Welcome to HEALTHCARE MAGIC..I have gone through your query and can understand your concern..As per your complain a boil over the upper eyelid can be a stye or a chalazion..In case if it is present just at the margin of eyelid it can be a stye while if it is present slightly away from eyelid it can be a chalazion..I would suggest you to do warm compresses over the eyelid and also put steroid eye drops..Do it atleast for a week and in case if it still does not resolve consult an Ophthalmologist and get evaluated and he can put steroid injections over the lump directly to shrink it..In case if it still does not resolve surgery is the only option left..Hope this information helps..Thanks and regards.Dr.Honey Nandwani Arora. </s>

<s>[INST] I have had pain in my middle right side back area for 10 days. Sleeping is difficult and painful. Can only sleep on my back, yet uncomfortable. Bending, stumping difficult and painful. Getting to sitting position and rising up painful and difficult. Advil doesn t help. [/INST] hi sir/madam,Thanks for your question on Healthcare Magic.Let me advice you for your problem.Low back ache may be a pre-monitory (prodromal) symptom in fistula in ano, sciatica, gouty arthritis, hernia, emaciation disorder etc. Pain is confined to lower part of the spine (back bone) especially lumbar region or lumbo-sacral area (rarely sacro-iliac region also). If it is secondary, earlier history of fall or injury may be associated. Rarely, radiating pain may be complained by the patient towards lower limbs. But it is quite common in low back aches if the defect is in the discs between vertebrae (back bones). Often the movements of lumbo-sacral region like flexion and rotation are hampered either partially or completely.Low back pain may be found in mild form in case of anemia, sciatica, rheumatoid arthritis, hemorrhoids, urinary calculi, uterine disorders etc also.Line of treatment as per Ayurveda:-The general principles of treatment of vata dosha are adopted in case of katishoola (low back pain). It includes various measures to suit its varied clinical entities, stages and associated complaints.1. Snehana (oleation) – by sneha dhara (pouring oil), abhyanga (oil massage), avagaha (tub bath with oil or oleaginous medicaments), kati basti (retaining medicaments on the back) etc.2. Swedana (sudation) –avagaha sweda (sweating treatment with tub bath), pizichil (kayaseka), nadi sweda (sudation through a tubular device – local sudation), panda sweda (sudation through medicated paste or powder) etc.3. Mridu Samshodhana -mild purgation.4. Basti (medicated enema) like eranda basti, vaitarana basti, pippalyadianuvasana basti etc.Formulations indicated in Low back ache as per Ayurveda:-1. Dashamoola kwatha.2.Maharasnadi kashaya.3. Rasnaerandadi kashaya.4. Sahacharadi kashaya.5. Gandharvahastadi kashaya.6. Trayodashanga guggulu.And for local application these oils will help:-1. Ksheerabala tail.2. Mahanarayana tail.3. Dhanwantaram tail.4. Maha narayan tail.Avoid these for better results:-1.Bitter, astringent and pungent food2.Cold water3.Fear4.Exhaustion5.Standing6.Driving7.Cold food and beverages etc.Yoga is also very helpful in treating your back ache.Now for your backache do these yoga aasana:-1. Ardha Matsyendrasana(Sitting Spinal Twist).2. Dhanurasana (Bow Pose).3. Marjariasana (Cat Stretch).4. Balasana(Child Pose).5. Halasana(Plow Pose).6. SUPTA MATSYENDRASANA(THE TWO KNEE SPINAL TWIST POSE).7.Adhomukha Shwanasana (Downward Facing Dog).8. Urdhva Mukha Svanasana(Upward Facing Dog Pose).9. Paschimottanasana(Seated Forward Fold).Follow these yogas you will get best results for your problems.Hope i was helpful.Have a healthy day. </s>

<s>[INST] Hello doctor, I have a problem with my teeth. I started using Hexidine mouthwash last month for whitening of teeth, but it is not helping me, and soon my teeth are becoming brownish at some places. What should I do to clean it? [/INST] Hi. Using Chlorhexidine mouthwash for more than 15 days in continuation causes brownish discoloration, that is the reason your teeth are becoming brownish. Now that you have developed chlorhexidine discoloration, I do not think scaling will be of any use. Instead, I would suggest you for either bleaching or veneering. Veneering is the solution for the type of stains that you have developed. Dental veneers are thin flakes of tooth-colored material, which are applied over the original teeth. Good luck. </s>

<s>[INST] I am an insulin dependent, taking human mixtard 25 units in morning & 30 units in night, aged 48 years from last fifteen days I am feeling severe pain in legs, and afternoon times severe tiredness, pls help, moreover I have undergonea hydronephrectomy in 1986. [/INST] Hello, As you are diabetic I will advise you to start doing exercises as most cases with diabetes will have some kind of a pain in the lower limbs and tiredness due to dysfunction of the metabolism. For improving the metabolism and improving the muscle strength for ADL one is always advised to do exercises. As your age us 48 it's always good to do some exercise rather making the muscles weaker. In my clinical practice of over 12 years, most diabetic cases have similar complaints and they do well with exercise as they keep on doing with regularity. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist </s>

<s>[INST] My sister is 8 years old. She has red bumps all over legs up to her stomach. Some of the bump gets big and some are already big. She says it hurts but it dosen t itch She says it bothers her and its rough. I don t think chicken pox because it dosen t look blisterish [/INST] Hi...by what you quote it could be HSP - Henoch Scholein Purpura. Skin conditions are best diagnosed only after seeing directly. I suggest you to upload photographs of the same on this website, so that I can guide you scientifically.Hope my answer was helpful for you. I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.Dr. Sumanth MBBS., DCH., DNB (Paed)., </s>

<s>[INST] got an allergy spreading all over my body.. what's the right dosage if i'll take celestamine table? or how many tablets a day? [/INST] Hi ilhen; welcome to HealthcareMagic Celestamine or for that matter any anti allergic should be taken after consulting a doctor.The dose of all medicines depends on body weight of a patient and is calculated accordingly.Please always consult a doctor in case of allergic reactions. Thanks </s>

<s>[INST] I have been seeing black fluffy like specks in my semen, I thought it probably was just blood, but it has been showing up for months, I am virgin and i do not have any STD, i am pretty worried about this, what do i have?also, I have back pain, it gets pretty bad after i masturbate, maybe I could have an infection? [/INST] HelloI appreciate your concern.Looking at your description, you might have got infection of urogenital tract, may be due to poor hygiene during masturbation.In my opinion you should go for urine test for microscopy and culture.according to reports, you may require a course of antibiotics under medical supervision.Meanwhile take plenty of fluids 3 to 5 liters per day either plain water or fruit juices, which will help by flushing off the urogenital tract.Maintain good hygiene.Hope I could answer your question, please feel free to ask for further clarification.Best wishes </s>

<s>[INST] Hi there. I just wanted to get an answer, I have the same thought reapeat over again all day and in the morning i get random songs playing in my head which slowly wear off to a word then that word repeats for few hours then goes away is this OCD I also have fear to touch things sometimes. [/INST] Hello,The symptoms point towards possibility of having OCD.Please see a psychiatrist in person, he will interview you in detail to pin point the diagnosis. Undetected and untreated this will persist and increase. Had i been treating you, i would have given you clomipramine 25-100mg daily at night along with therapy session for thought stopping and ERP.Both meds and therapy are essential for complete cure of this illness.Wish you good luck.Dr. Manisha GopalMD psychiatry </s>

<s>[INST] well my grandads just recenly passed away and i just dont feel up to anything i hardly go to school my friends knock i just want to be with people i just dont want be be aloe , its been a while since he passed away and i just carnt see up to doing anything can you help me ?? [/INST] HiWelcome to HM.I understand your concern.It is not depression. It is Grief reaction.Grief can be define by felling of emotional instability due to loss of loved one.It is natural to some extent.But when it interferes with daily routine it suggest pathological grief.Better to wait for any drug till 2 months. Usually it will resolve within 2 months.Try to keep yourself busy.Discuss with family and friends.Accept what you have lost and reality.Accept what is now you have and what you will be.Because it is fact that you have to do all this to come out from it.Do not be alone as you talk with people it helps in adaptations.This condition can be treated with mild dose of SSRI and benzodiazapin if it affects you more.still have a query then feel free to ask.Always here to help you.Thank you.Take care. </s>

<s>[INST] My daughter has an indentation in her upper left arm. It is about the size of a quarter. It appeared all of a sudden with no known injury, but is slightly painful when lifting or pushing on it. An MRI was done and the tech said there is a knot under it. We do not have official results yet. Any idea what it could be? [/INST] Hi ! Good evening. I am Dr Shareef answering your query. I would advise you to consult a general surgeon along with your reports, as it is not possible to opine on it simply on the MRI report without a clinical examination. If the MRI is inconclusive, there may be a need for a FNAC (fine needle aspiration cytology) for a histological diagnosis. The surgeon has to decide on this investigation. Wish your daughter an early relief of the problem.Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. Wishing you an early recovery. Dr Shareef. </s>

<s>[INST] I am a 67 years young female. Have hypertension which I am taking meds for but otherwise I am in good health. Just had my remaining bottom teeth (10)pulled July 7th. All went fine but my gums on the right side of my face right about the jawline is sore and seems like its swollen. It's sore to the touch. Will see my dentist again on July 18th but how can I get the swelling down until then. Thanks [/INST] Thanks for your query, I have gone through your query. The swelling over the gum could be because of the infected gums or any root pieces left in that region or osteomyelitis. consult a oral physician and get a radiograph done and rule out any infection arising from any left out root pieces or bone infection. if there are root pieces get it removed, take a course of antibiotics like penicillin and metronidazole combination. do saline gargling. i hope my answer will help you, take care. </s>

<s>[INST] How large can a localized* renal cell carcinoma be and still be effectively treated via embolization. *There has been no renal vein or tumor membrane invasion, and no lymph node involvement. The tumor was discovered after sudden onset of back pain, nausea, vomiting, fever. Blood tests were done with a-symptomatic results. CT Scan revealed a very large tumor that has totally involved the kidney. Surgery is scheduled within two days. [/INST] helloThanks for query.Only treatment option for large Renal Cell Carcinoma involving whole kidney is Radical Nephrectomy.Renal Cell Carcinoma of even a small size can not be treated by embolization.Go ahead and get surgery done .Dr.Patil. </s>

<s>[INST] Dear Doctor,My mom (57) 156 cm, 115 pounds, had very recently gone for dental consultation to a reputed specialty. A couple of routine tests were asked to be taken which are OPG - Digital, CBC, RBS, BT, CT and PT. After examination they formulated a treatment plan which includes -Scaling and polishing- Lower arch - Dental implants under local anesthesia, with or without adrenaline 1 is to 80000- Upper complete dentureThe following medication would be givenCap Phexin 250 mgTab EnzoflamWe have also provided them a brief medical history of my mother which includes her medical condition known as Idiopathic Generalized Epilepsy, from what we understand from her symptoms for which is taking Tegretol, 200 to max 400 mg day. As per observation her seizure occurrence has been 2 seizures a day that occur every 15th or 16th day or at times an episode of seizure if highly stressed or unwell or traveling bound.We are satisfied with the treatment plan provided by this dental clinic. Now since she has this specific epilepsy condition that I mentioned above, we have been asked to get her family doctor or the doctor under whom she may be getting treatment for epilepsy to provide CONSENT letter about her general health so as to proceed with the dental treatment without any further complications.As such she does not have any specific doctor that has been treating for her for this condition and perhaps as suggested by some doctor in her late 20's she was recommended Dilantin, and then later on Mazetol and for last several years she is taking Tegretol which has pretty much kept her seizures in control. Although she has never been seizure free for a consistent period of time in spite of regular use of these medication, but to a large extent it is the only support system for her. I have read of anesthesia without adrenaline for epileptic patients and also that most epileptic patients can successfully get implants done.Could you please suggest what would be the correct course of action to be taken to avoid the least amount of risk or complication, before, during and after this treatment. [/INST] HIThank for asking to HCMI really appreciate your concern for your mother if your mother is epileptic patient and now she suppose to go for teeth extraction then no need to worry about this only matter is dentist should be inform for this and your mother would taken a great care, hope this information helps you, take care and have a nice day. </s>

<s>[INST] Hi doctor, My son is 6 years old and has been diagnosed with ADHD, ODD and sensory integration disorder. He had Adderall XR 5 mg for a while and recently was changed to Strattera 27 mg. My son has been experiencing major insomnia, high aggressive behaviors which involved throwing objects at people, hitting, punching people, kicking and biting especially adults. As his mother I do not believe that he has ADHD. Although he has ODD, it is a normal thing in a 6 year old. However, the behavior is not becoming better and it has actually become worst to the point where he is on the verge of being kicked out of everything. I want to take him away from all medications, because I do not want my 6 year old on them to begin with. However, I am out of ideas and it scares me because my son could be really wonderful, but currently he is not at all. Can you help me with any suggestions? [/INST] Hello. Revert back with the answers to an internal medicine physician online --> </s>

<s>[INST] i am recently being diagnosed with Hep B as my wife and a child does not have this desease. I visited doctors in many of the hospitals and was advised that, i don t need any treatment further as it s virus is under control. If i would start having this Liv.52 HB, is there a possibility that, i could be cured completely & if yes, for how long do i need to take it. I shall, indeed thank you for your valuable advise in this regard please. [/INST] Hello, Individuals who remain HBsAg positive for at least six months are considered to be hepatitis B carriers.Carriers who have seroconverted to HBeAg negative status, in particular those who acquired the infection as adults, have very little viral multiplication and hence may be at little risk of long-term complications or of transmitting infection to others. However you should keep on monitoring your ALT levels and if they are ever found above 60,then you would require the treatment with interferons and immune modulators. 40% of individuals with hepatitis B having normal ALT have hepatic fibrosis. Treatment with LIV -52 has no role. One can never get rid of HEP B,if he is having this infection for more than 6 months. Keep in regular touch with your gastroenterologist and start the treatment immediately,the moment you find that there is reactivation of the disease. Get your wife and child vaccinated with HEP B vaccine. Thanks </s>

<s>[INST] I was diag. with mild low oligo last week. I am 25 Wks. Everything else looks fine. Baby is growing fine with no problems. Why would my fluid be low? I was low/normal 2 weeks earlier. What are the statistics that all will be fine and deliver closer to due date? And what are the benefits of bed rest? [/INST] Low AF volume has many causes, from low production to fluid loss due to rupture of the membranes. Since you are fine and did not report fluid loss from your genitalia we can dismiss that as a probable cause. Next we must consider low production due to kidney absence or malformations but that do not seem to be case either. Another cause is placental insuficiency but the baby is doing fine and growing as expected for a normal pregnancy. Being that said I would mention a seldom considered cause, that is, poor maternal hydration. Before considering that you ask for an appointment to perform Doppler studies of the placental-fetal circulatoon I would suggest you drink more water during the day, water, not juices and sodas, water. Within hours AF level could improve. Good Luck! </s>

<s>[INST] I have been suffering with toothache and was told by the pharmacist to take ponstan 500mg...im 120kg and have taken 10 so far today and nothing!!! Help!!! [/INST] Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. Only pontan will not help in toothache. It needs to be covered with antibioticis + mouth wash for local effect. So visit a dentist for evaluation. Hope I have answered your question. Let me know if I can assist you further.Wish you a good health!Regards,Dr. M. Imran Javid </s>

<s>[INST] Hi, I am a frequent masturbater, 3-4 times a day, everyday. I ve noticed that I don t really produce a lot of ejaculate anymore if at all and well, my wife and I are wanting to concieve for a child, I was just curious as to how this would affect our chances in trying to become pregnant? Thanks in advanced. [/INST] Hello there, Imagine your semen stores to be like a bottle kept under a tap. It needs time to fill up. If you masturbate frequently then when you ejaculate the volume of semen would decrease with each ejaculation . So if you are planning to conceive then avoid masturbation for some time and you would see your ejaculate increase in volume. Hope this helps you.Please feel free to ask for any further clarifications.Dr Arun A </s>

<s>[INST] Hello, about 3 weeks ago I was stung in the forehead by a honeybee and my entire face swelled for days. Received cortisone and antihistamine shot the next day. Eventually it all settled. A few days ago I was somehow stung by (I think) mosquitoes on my legs (8 stings) and I reacted terribly with swelling, itching and wheals... it is getting slowly better, but a friend told me that reaction may have been caused by the cortisone shot I had receive a few weeks ago. Does that make sense? Thank you! Michele [/INST] Hello,Welcome to HCM,As you were stung by the honey bee it will causes localized reaction like swelling of the face and aother reactions.I would suggest washing the area with soap and water followed by application of ice over that area.You can apply a steroid cream like hydrocortisone or fluticasone cream two to three times, this will helps to resolve the redness and treat localised reaction and inflammation.Atarax drops, 3 drops twice in a day for two to three daysThe aforementioned measures will help to improve the condition.Thank you. </s>

<s>[INST] Hi doctor, During masturbation I just rub the tip of the penis and not the entire penis. Is it a wrong way of doing? I do not get excited during sex and unable to ejaculate. Only, rubbing the tip of the penis gives me excitement. Also, two weeks ago, I have undergone circumcision as my foreskin did not retract. Before circumcision too, I have the same problem. Please help. [/INST] Hi. For further doubts consult a sexologist online --> </s>

<s>[INST] I have seizures and have been on phenobarbital and dilantin since 1999, and take 5ml of Dilantin 3x a day and I take 60mg of phenobarbital in the morning and 90mg at night is there a different drug out there that would work and I wouldn't have to take it as often? [/INST] Dear I am sorry for your health problems.These last 10 years there are been so much developments for treatment epilepsy.I will strongly recommend to take contact with a neurologist and change your treatment.Wish you all the best </s>

<s>[INST] hi,im jnkna im twenty one,i have been married for two years,and i have been trying to get pregnant for three years now,but no luck,i have had so many test with my body with a gynae,but found nothing wrong,i have irregular periods and suffers from anaemia,but they say that its got nothing to do with the fact that cant conceive,my husband is 31 and doesnt have any children,he is not a fan of alchohol and cigarrettes,so what could be the problem? please help me [/INST] HAI WELCOME TO HCM UNEXPLAINED INFERTILITY IS THE ONE REASON WHERE PEOPLE WONT CONCEIVE AFTER ALL NORMAL TEST REPORTS.IT MAY BE DUE TO FAILURE OF FUSION OF SPERM AND EGG.INVITROFERTILISATION IS THE TREATMENT OPTION FOR YOU TO CONCEIVE.CONSULT AN INFERTILITY SPECIALIST. </s>

<s>[INST] Hi, I have a disc hernations are C-5,6 &7. I see my endocrinologist yearly, (a little over due), - when the neurosurgeon viewed my cervical MRI, he noted a large thyroid with nodgles - which I already know. My question is - can a large thyroid/goiter with nodgles cause a cervical hernation? [/INST] Hi,Actually it is a rare condition but I think in your case it may have exaggerate the underlying cervical disc herniation. I think your neurologist can give you a more precise answer according to your cervical conditionHope the above information helps you. Any further clarifications feel free to ask.Regards,Dr. Ahmed Aly Hassan </s>

<s>[INST] My husbandMy husband has been having sharp pains in his head. He has alcohol enduced seizures. But he has been having them without drinking. Now for the last 3 days he has had a headache, and NOTHING he does or takes will help. Even when he is asleep he wakes up from the pain in his head. Also about a week or so ago he was riding his bicycle and passed out and woke up laying on the ground with a bloody nose. he had had a few days in a row that he had bloody noses. I am really worried that it may be a tumor. Please help [/INST] Hai.beimg chronic alcoholic he is more prone for all complications like diabetes, bp, atherosclerosis, high cholesterol, which can all be the cause for cerebrovascular accidents and cardiac problems. Complaints of headache, epistaxis (bleeding nose) all this could be due to any problems in the brain , like sub arachnoid haemorrhage, high bp,.pls do a ct brain, or mri brain, sugar levels, kidney test, liver function test by checking all his haemodynamic parameters, and coagulation profile, u can either meet a neurophysician on euro surgeon, they will surely help </s>

<s>[INST] I have diverticulitis and was prescribed ciprofloxacin. Once I finished my prescription I got a really bad yeast infection. It's been 3 weeks and I still itch. I also take metformin....sometimes because it makes my heart beat fast. So I stop taking it. But I'm tired of this rash.....what should I do? [/INST] Thanks for your query at HCM!I am Infectious Disease Specialist! I went through your query!Please continue your metformin and consult your physician before stopping. Describe your lesions in detail? Which part?Apply topical clotrimazole cream twice daiy for 7 days. Single stat dose of oral fluconazole is also the treatment for a candial infection.Also intake of oral antihistamine like either cetrizine, fexofenadine or loratadine(10mg once) once or twice dailyHappy to take more queries! You can also write a review for me. If you would like some more information, I will be happy to provide. You can take a follow-up query.Take care!Dr. Sheetal VermaInfectious Disease Specialist </s>

<s>[INST] I am just trying to see if there is a cause for my step mother's pottassium to drop. She is undergoing the process of finding out where her cancer has originated but they cannot do any surgerys, etc. until her potassium is in normal range. I t will come up with medication, but then drop again. I was just looking for what might be the cause. [/INST] Thanks for your question on HCM.There are many causes for potassium loss in cancer patients. But the most common ones are.1. Poor oral intake.2. Excess loss in urine.3. Excess loss in stool (diarrhoea).Cancer patients tend to have poor appetite. So their oral intake is low.If cancer has spread in kidney than this csn alter the function of kidney and cause excessive loss in urine.Cancers patients are prone to gastrointestinal infection as their body defence is weakened. So diarrhoea can be the cause.Better to start potassium supplements. </s>

<s>[INST] hi, i want to ask out of so many desensitizing toothpastes available of different brands and withing the same brands. on what basis should we choose?eg out of sensodent,sensodent K,sensoform and sensodent KF? Can such tooth pastes can be used over a prolonged period of time? [/INST] Hello,Choosing a desensitizing tooth paste depend on your degree of tooth wearing and the amount of sensitivity. You should start with a very basic one like plain sensodent , apply for 10-15 minutes, do it for two times daily for at least 1 week. If you did not feel relief from that then you should visit your dentist as he will examine the tooth and then prescribe you what is needed, as without proper examination just experimenting with anything is not done.Hope it will help youThank you </s>

<s>[INST] Hello doctor, I am 18 years old and I have been prone to masturbating for the past three years, and now I have erectile dysfunction. Is there any way I can treat this without any medication or any surgery? I have not consulted any doctor yet. [/INST] Hello. Masturbation is normal and does not cause physical problems or sexual problems. Also, do not give any importance to an advertisement that mentions that masturbation cause health problems or destroys life, and masturbation does not require any treatment. Erectile dysfunction can be due to stress or anxiety or due to a physical cause. For physical cause, you need to do some blood tests like sugar and hormones. Stop smoking if you smoke. If you are taking any medicine or nutritional supplement on regular basis then it may be due to the side effect of that. But general exercise will help you. </s>

<s>[INST] I took Postinor2 less than 24 hours after sex and the other pill 13 hours after that. I know I need to eat it in 12 hours time but something happened and I took it one hour late. Does that affects the effectiveness of Postinor? Do I need to get another set of pills and take two right away to reduce the risk of getting pregnant? [/INST] . Hi thanks for your question. You have to take postinor 2. Postinor 2 can help to prevent you from getting pregnant, after unprotected sex, The first tablet has to be taken within 72 hours (3 days) of unprotected sex. The tablets are more effective if they are taken as soon as possible after unprotected sex. You need to take 2nd tablet 12 hours (but no more than 16hours) after first. So relax you have taken the medicine well within the prescribed limit. Hope I answered your question. </s>

<s>[INST] Hi,my guestion is this,12 years ago I had rotator cuff surgery,when the Dr.was doing the surgery he found a calcium ball in my arm he said it was the size of a mans thum knuckle,I been having pain around the same spot where the calcium ball had been,the doctor sent me for a MRI it show everything was fine,I also so had a MRI 12 years ago before my surgery,it DID NOT SHOW THE CALCIUM,my guestion is this can this be my problem again and if so why doese nt the calcium show up in a x-ray,or MRI? Thank You [/INST] Yes, it may be part of side effects of chemotherapy, but some investigations should be done first. It may be acute gouty arthritis so serum uric acid should be done first.You must not be worry early about this. I hope you are well. </s>

<s>[INST] I had two fillings done today on the lower teeth, one was very deep and a large dose of anesthetic had to be used. The numbness was still around after 3-4 hours and I ate something small 3 hours later when I still had some numbness although I tried not to chew on that side of the mouth. I now have severe headache on my forehead and top of my head, its gradually worsening and keeping me up. What could the headache be from? [/INST] Heloo pt-The most likely explanation to your symptoms is that the nerve inside the tooth may be inflammed. This can occur when the cavity and therefore the filling is very close to the nerve inside the tooth. The condition is called irreversible pulpitis and the treatment is root canal therapy. There are simple tests a dentist can do to confirm this diagnosis. The radiating pain you are describing is not uncommon with inflammed or infected teeth. </s>

<s>[INST] hi, i am a 39 yr old female, and absolutely terrified of the dentist, haven t been to one since i was in high school (or earlier) and it s caught up with me with a vengence...just in the last 3 months i ve lost 3 of my teeth in my lower jaw...they just appeared to be loose one day and eventually just came right out...since then, my front teeth are now getting looser and i ve gotten a few puss pockets in my gums as well...i m really scared, and i mean totally terrified on what to do [/INST] Thanks for your query, I have gone through your query.The loose teeth could be because of the gum infection secondary to deposits.Consult a good dental surgeon or periodontist and get your teeth cleaned(scaling and root planing) once and maintain the oral hygiene after that. You have to get your teeth cleaned once in a year. You have to take a radiograph to check the bone level in all the teeth.I hope my answer will help you, take care. </s>

<s>[INST] Dear sirWe are done MRI scan that result as below 1disc desiccatiin is seen at L3-4 to L5-S1 levels2 Diffuse disc bulge at L3-4level causing thecal indentation.3 Diffuse disc bulge with annualr tear and facetal arthosis at L4-5level causing thecal. [/INST] Hi,1disc desiccatiin is seen at L3-4 to L5-S1 levels this signifies that disk of your lumbar spine degenerated due to ageing process which is irreversible and responsible for back pain.2 Diffuse disc bulge at L3-4level causing thecal indentation means mild dural /cord compression result in numbness and tingling in legs.3 Diffuse disc bulge with annualr tear and facetal arthosis at L4-5level causing thecal denoted arthritis of small joints of spine which again a degenerative condition.but your MRI not look terrible from surgical point of view.just do physiotherapy. </s>

<s>[INST] Hi doctors, I have a question. Yesterday my mom and our puppy (2months old) were playing then suddenly our puppy playfully bit my mom's hand. The teeth scratched her hand, the wound looks like a tiny dot but it also has a tiny blood. I am nervous because our puppy has not had any vaccination because it's still young. Is it dangerous? We quickly washed it and put a lot of alcohol. [/INST] HelloAs you stated that your dog was not vaccinated and , dog bitten your mother , so get in human diploid cell vaccine ( HDCV) or purified chick embryo vaccine 1.0 ml ( deltoid muscle )one each on days 0 , 3 7 and 14 .Also cleanse the wound and also get in tetanus injection.So consult a physician and take these injections.Also get in vaccination for your dog. </s>

<s>[INST] Which of the following medications are blood thinners: Levothyroxine Cialopram Minoxidil Hydrochlorohiazide Valsartan Januvia Oxybutynin Pravastatin Sodium Bysolic Pramipexole My husband is having surgery and needs to stop taking any blood thinners. Thank You XXXX [/INST] Hello, None of the medications you have mentioned is a blood thinner and he should not stop any of these without consulting the doctor. The medications you wrote are for thyroid problems, hypertension, high cholesterol, depression, muscle spasms (Parkinson), etc. I hope this answers your query. I remain at your disposal in case further medical assistance is needed. Regards, Dr. Antoneta Zotaj, General and Family Physician </s>

<s>[INST] I went to the dentist today. She stated she used septocaine. While giving administering the septocaine, sparks were shocking me and burning my tongue . After the septocaine wore out, my tongue is raw and there are puncture marks on my lips . Are there chemicals in spectocaine which could possibly have similar signs affects? [/INST] hi, Septocaine is a local anesthetic which usually does not have any side effects until one is specifically allergic to it, which is a rare occurence. while giving any local anesthetic there is a burning senstation in the area where the material is getting deposited, which is normal. If your dental procedure took a long time then the cracking of lips and raw tongue maybe due to cnstantly keeping your mouth open. lips get dry and crack when the mouth is open for a long time, applying any good lip balm should solve the problem. if the discomfort persists or increases, i would strongly recommend that you consult your dentist. Regards </s>

<s>[INST] Hi my 3 month old has a bad rash all over her body. It itches her and we don't know what it is its even in the palm of her hands what can it be I've tried everything what can I do nothing's working we live in Korea but the health care for military isn't very good please help she's been suffering since 1 month she's on nutriguiem milk. [/INST] Is this rash recent? It is probably alergic. It could be related to the new milk he is on, or it could be an alergy from other environmental cause. Considering the age, you should see a doctor as soon as possible. There are other causes of skin rashes in this age, and not many medications approved for small children. </s>

<s>[INST] my son 17months and 5 days old. he wakes up crying every night few times, cannot make sense as he is not tired, he is not having night mare as he can see us talking to him, but screams out loud if we try to comforts him. he was not like this till April as he started doing it after we came back from overseas. [/INST] Hi dear,If recent onset after a travel, this may indicate some systemic infection going on,especially there is refusal to feed, nausea etc.Kindly see your doctor for evaluation .Take care.Thank you. </s>

<s>[INST] Hello doctor,I have done a CT scan of the brain recently and found everything was normal but with mega cisterna. The report shows scalp hematoma but that was from childhood and operated. I am worried about mega cisterna. Please suggest. [/INST] Hello. I have gone through the reports (attachment removed to protect patient identity). Your CT scan is normal. Mega cisterna magna is a normal variant. So do not worry about that. Scalp hematoma is a collection of blood outside your skull (bone) and is, therefore nothing to worry about. It cannot be due to very old injury as it usually gets absorbed or calcified. It may have resulted from a minor trauma that you may have forgotten. For more information consult a neuro surgeon online --> </s>

<s>[INST] Hi , I was stretching in my dance class .. And we were doing like this stretch with our legs spread apart (like the splits) and wen I was reaching for my right foot , I heard a crack sound . I started to feel pain near the groin an upper thigh area. I was wondering if I popped it .. Or pulled something ? [/INST] Hi, In my opinion, you have pulled your hamstrings. I suggest pain killers, muscle relaxants and local heal. If no relief in 2-3 weeks then an orthopedic consultation is indicated. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Gopal Goel, Orthopaedic Surgeon </s>

<s>[INST] MR imaging reveals diffuse disc bulges at L4-5 and L5-S1 levels indenting the thecal sac with mild narrowing of bilateral neural foramina......................and doctor recommended me Laser surgery ...and don t know what to do at this age..Isn t there any solution out...as every doctor gives me his personal different advise...some says medicines and some exercise and some surgery and some says it is normal so don t be panic just take medicines [/INST] Hi Ayush, MR image showing disc bulging is very common however it is very important in spine to match clinical symptoms and MRI finding. I need to know about the severity of the problem? location of pain? and your MRI images especially cuts at L4-5 and L5-S1. By the way what's your age right now? If you have significant leg symptoms then i would consider doing epidural block. Laser surgery is a marketing tool rather than a research proven technique and I would not suggest that from this information. Medicine and exercise is obviously better option if it is bringing your pain under control. </s>

<s>[INST] hi, I fell down the stairs 2 weeks ago and hurt my leg, the way I fell I landed on my shin, there was a bruise but now that its gone there's a small hard lump under the skin about the size of a pea. its sore to touch, and I still feel pain while I'm walking. do you know what this could be ? [/INST] hi I understand your situationyou got hard painful lump after traumaDiagnosis:its most probably a sub-periosteal hematoma formation due to direct trauma to your shin then gradually became harden due to fibroses.it will be painful due to movement and touchingTreatment:you can let it and apply gentle pressure over it with taking topical or oral painkillersif no benefit you can excised by surgery by specialist. </s>

<s>[INST] I have this deep muscular pain in my left shoulder chest area. I can t sleep on my left side. It hurts when I breathe deeply. Also I cant hold a cup of ice water too long on with that arm....I had simular pain in my right arm for 10 years before it went away... [/INST] hi,thanks for mentioning little history about you. you should meet a cardio or a physician if it is a left sided pain. if they give thumps up that all is fine then you should do some regular breathing exercises and also some simple strengthening exercises for hand and legs. it will help you. but if the symptoms are bothering than get checked once. there is no harm in getting checked.thank you </s>

<s>[INST] i am 27 years old now.. recently i had undergone a pelvic ultrasound and the doctor diagnosed me that i have PCOS. Me and my husband are trying to have a baby now.. the OB give me an OVAMIT.. i had take it once.. ahmm, actually we already have one child.. a baby girl.. and shes already 4 years old now.. buy that long years we dont have any baby yet.. even a sign of pregnancy.. i dont even taking pills or any family planning.. my hubby and i are usually do the natural method... not even wasting any sperm cells just to be get pregnant... for that year long we really miss to have a little boy... pls help us...pls give me any medicine that would be work better than OVAMIT... i am begging... plsssss.... best regards [/INST] Hello, Thanks for the query to H.C.M. Forum. Ovamit ( clomifene ) is used in anovulatory infertility . As you are having pcos and already there is one daughter so you are a patient of secondary infertility . Causes of infertility may be . 1 anovulation , diagnosis can be confirmed by study of follicles and also study of dominant follicle. 2 uterus is unable to receive fertilized ovum . Diagnosis can be confirmed by study of endometrium thickness , if this thickness is less then 10 mm , no chance of pregnancy.3 Hormonal imbalance may be the another reason of secondary infertility . Diagnosis can be confirmed by blood examination of estrogen , androgen , F S H / L H ratio. In my opinion first of all consult a gynecologist and after all above mentioned measures , deal accordingly . Good luck. Dr. HET </s>

<s>[INST] Hello doctor, My grandmother is 90 years old. She had a brain hemorrhage two days back. She is in ICU. She is unconscious from the last two days. There is toe movement and sometimes, there are some leg movements. She has high blood pressure. The doctors in my place are saying nothing can be done. What are the options that we have now? [/INST] Hi. External ventricular drainage. For further information consult a neurologist online.---> </s>

<s>[INST] hello, if someone has those symptom of lupus that they might have it? [/INST] hi lupus is not only skin disease it involve many system so if u have those symptom that does not mean that u have lupus you should consult dermaatologist for this </s>

<s>[INST] I was wondering what would happen if a 17p progesterone shot were accidentally given into a vein instead of the muscle? I give them to myself weekly because i am pregnant with triplets and always aspirate to make sure it s not in a vein, but was curious as to what would happen if it did go into a vein? [/INST] HiHormones are to be injected only into the thigh or buttock muscle.Hormones generally have a suspension like consistency and when injected into veins, blood clots can appear in the veins of the legs and can travel to the lungs. In severe cases it can also cause pulmonary embolism, which can be fatal.Hope that was helpful.Let me know if i can assist you further.RegardsDr.Saranya RamadossGeneral and Family Health Physician </s>

<s>[INST] I am currently having an IC flair up (which I have not had in a long time and it had been controlled with diet); I am also experiencing upper respiratory allergy symptoms (sinus drip, sore throat, coughing). I do have an appointment with my family dr. this after noon. What kind of treatments should I expect? Do you have any suggestions. [/INST] Hi thanks for contacting health care magic...Noted you have flu like symptoms...Sore throat , cold etc...It may be viral or allergic infection....Symptomatic management done...For cold decongestent taken like oxymetazoline.... If it seems pure allergic and if feel by doctor he might prescribe you azelestine antihistaminic nasal spray ....Cetrizine also useful....I would like to suggest you to do your CBC .If lymphocytosis viral and if eosinophilia allergic could be cause....Drink more water....Steam inhalation useful....Avoid excess spicy food...You will recover within few days....If still not improving then according to your physical examination further work up will decided....Take care...Dr.Parth </s>

<s>[INST] If I m talking sprintec birth control pills and I finished all the blue pills, and now taking my inactive white pills, but I don t have my period, and a guy ejaculates in me , can I get pregnant, or is the active pills still working in my body. It s been three days, with no period and taking the white pills, and my bf has ejaculated in me [/INST] Hello dearUnderstand your concernYes you are protective if you had take all the active blue tablet regularly.Now no matter your partner ejaculate inside the vagina as you are fully protective. Continue your inactive pill and finish it. Bleeding will come in next 4-5 days.Chance of pregnancy is nil because1. You had sex in safe period of cycle2. Fully protective by contraceptive pill.Avoid stress, eat healthy diet, drink plenty of fluids and do regular exercise and yoga.Hope this may help youBest regardsDr. Sagar </s>

<s>[INST] In 1994 I had a brain aneurysm clipped. Symptoms were awful headaches. The aneurysm didn't burst, but had leaked. in 2009 I had gastric bypass and have had multiple hospitalizations since for mainly infections, the last being sepsis. I've been vomiting the last month, several times per week and last week it was so violent it gave me a massive headache similar to the ones I had with my brain aneurysm. Should I be concerned it could be another one? [/INST] Yes it is a matter of concern with your noticeable past history.. I suggest you should do a MRI or CECT brain after consulting with a neurophysician.. </s>

<s>[INST] Hello doctor, I have multiple small cysts in both ovaries (PCOS). Our family friend suggested me to consume Kalarchikai medicine, powdered mixed with pepper and honey to have it for one mandalam (48 days). I have completed nearly 44 days by consuming one small ball of the mixture every morning and before two weeks I got my periods. Then I had checked whether the cysts were dissolved by having an abdomen scan. But still, small multiple follicules have been seen in it with both ovaries enlarged. Kindly suggest me what I can do further. I got married before one and a half years and I am much worried about my pregnancy. I have gallstones as well. [/INST] Hello. I just read your query. See Kalarachi Kai choornam is helpful in amenorrhea. As far as small cysts are concerned they are unmatured eggs which failed to induce menstrual cycle previously, as a result, they got collected in the ovary and they will remain in the ovary. Now, you have got your periods you can start trying for conception. But I advise you to do it under the supervision of a nearby gynecologist because egg size is important while conception and that you can know by ovulation study. Ovulation study is performed under the supervision of a gynecologist. For gall stones, surgical intervention is required generally. Medicine is not of much help. </s>

<s>[INST] Hello doctor, My husband consumed one full cap of Lizol. Can it cause serious things? Should I go to the doctor immediately? [/INST] Hello I am assuming that by Lizol you are referring to the disinfectant and floor cleaner. Yes, there are possible toxic complications if your husband does not seek medical care immediately. Please give him two glasses of water to drink and go to the emergency room immediately. Symptoms that may develop are nausea, vomiting, and diarrhea. There are other more serious complications that a doctor at an emergency room will be able to monitor for. All the best on your trip. Please do let me know how things are going once you reach the hospital. Blood tests to be done - CBC (complete blood count), electrolytes, urea, creatinine, calcium, magnesium, and phosphate. Treatment - Vitals monitoring, intravenous fluids, 24-hour observation. For more information consult a general practitioner online --> </s>

<s>[INST] Please read the below case history & awnser the questions at the end Mr. Gurcharan Singh / Male DOB: 24.12.1936 Initially Strong Athletic Built / Non Vegetarian / Tea totaller / Strong Willed 1980: His BP raised to 170/250 and effected all vital organs, resulting swelling in brain, heart enlargement & renal failure (RCF). One of his heart beat got missed in readings of ECGs. He was treated in PGI, Chandigarh (India) and was put on to medicines. 1993: He was taken to local cardiologist due to sudden excess nose bleeding & said cardio physician put him on to some medicines for keeping the BP low. 2001: He felt angina pain in the chest. Was again taken to PGI, Chandigarh (India) for angiography & then was shifted to Escorts Heart Hosp., Delhi (India) & Heart Bye Pass surgery was performed there (CABG done (LIMA to LAD)). 2002: Dr. K.S. Chug (Ex – HOD, Nephrology (PGI-Chandigarh) was consulted. He pointed out that though his BP is stable (80/140) but Urea, Cratenine was on higher side (Createnine – 4.5 & Urea – 132) and put him on additional medicines for the same. Below said is the complete medicine list that was recommended: 1.     Tab Dytor 20 mg, once daily 2.     Tab Amlopres 5 mg, once daily 3.     Shelcal 500 mg, twice a day 4.     Alfacip 0.25 mg, once daily 5.     Heamup (Iron), once daily 6.     Clavix 75 mg, once daily 7.     Simcard 10 mg, once daily 8.     Razo-D (SOS, if vomit sensation persists) 2005: He again had a severe nose bleeding & nose coterie procedure was done in Silver Oak Hosp., Mohali (India) by an ENT surgeon. 2007: Fistula was made on his left wrist due to Ctatenine – 7.5 & Urea - 220. Consulted dietician again and started recommended dietary precautions & strict medicine routine. Feb’ 2010: -     Started taking Homeopathy medicines along with allopathic medicines (primarily as: BERBERIS VULGARIS & ECHINACEA ANGUSTIFOLIA) from a qualified Homeo Physician -     Started checking parameters (Urea & Cratenine) on monthly basis & after 2 – 3 months of homeopathy medicines, slight reverse trend in the said parameters was observed for the first time in last 2 years. BP is observed stable on the whole. -     Fistula was never used for dialysis but it started budging out like a water filled balloon so we approached local surgeon for closing said fistula & he did the same for us. -     Swelling in the feet, itching on back side of neck, less appetite, laziness (feeling sleepy/drowsy in whole of the day time), red/blood coloured patches on his hands & arms, etc. were discussed with homoeopathic physician on weekly basis and with his medicines the same got partially managed. -     Body immunity level seems low as frequently catching cough, cold, etc. increased. -     Hernia problem also there from quite long but aggravates rarely and got subsided of its own after some time (5 – 6 hrs.) Oct’ 2010: -     Mucus (chocolate/brown coloured) vomiting -     Severe giddiness/dizziness Was immediately taken to Local Hosp. & was observed in ICU for 24 hrs., CT Scan/MRI done and everything was found normal. Then it was guessed that it may happen due to intake of vegetable with high urea/pesticide spray or aftereffects of Iron capsule (was regularly taking Iron capsule from last 5 -6 years) Jan’ 2011 – Jun’2011: -     Cratnine toggled between 6 to 7 -     Urea toggled between 180 to 195 Jul’ 2011: Cratnine reached 7.8 Oct’ 2011: -     Cratnine crossed 8 -     Continuous low appetite / itching on back of neck increased / vomit sensation quite frequently / drowsiness increased during day time / feeling chest pain once to twice a day -     Got him admitted in local hospital : •     Angiography done: CART done on 15.11.2011 s/o triple vessel disease, patent graft and cardiologist advised that his angina to be controlled with medicines itself as major blood vessels are in OK shape & only a small blood flow interruption in one of the minor veins so no need for putting stunt. •     Found that suffering from chronic kidney disease stage V , chronic AF/CVR, unstable angina, hypertension, BPH, coronary artery disease P/S CABG in 2001 (LIMA to LAD). Having frail body & weighing 50.4 Kg. •     Started hemo-dialysis ( done on 15 oct, 17 oct & 25 oct) Now it is recommended by the nephrologist that Mr. Gurcharan Singh being a heart patient should opt for Peritoneal Dialysis & surgery to be performed to tackle his hernia, making fresh fistula again & putting catheter in his kidneys. Presently he is on below said medicines: 1.     Tab Pantocid-D, twice a day (empty stomach) 2.     Tab Urimax-D 0.4 mg, once a day 3.     Tab Clavix 75 mg, once a day 4.     Tab Flavedon MR, Twice a day 5.     Tab Monit GTN 6.4 mg, twice a day 6.     Tab Modlip-ASP (10+75 mg), once a day 7.     Tab Dytor 40 mg, once a day 8.     Tab Shelcal 500 mg, twice a day 9.     Tab Alpha-Cip 0.25 mg, once a day 10.     Tab Nikoran 5 mg, twice a day 11.     Tab Amtas 5 mg, twice a day Our Queries: 1.     What type of dialysis is best for him & why? 2.     Generally, till how long he can comfortably continue with present heart & kidneys situation. 3.     He has been given his first hepatitis shot on 15th Oct’11 & said injection course shall be continued till Apr’12. How to protect him from any type of infections till then? 4.     If peritoneal dialysis is recommended, then: -      it should be done manually (3 times a day) or with machine (Baxter brand is available here). -     What all precautions needed to be taken for making the possibility of infection as ZERO. -     Dietary routine (extensive list of items: ‘To be taken with qty.’ & “Not to be taken”) 5.     Other precautions (living routine / medicine / diet / which path tests with what frequency) 6.     His HB is low as 8.0 so if we will go for HB increasing injections then how to control his BP? [/INST] Hello Gursharan and welcome to HCM.As an Urologist,i can understand your concern.Your question takes time.You've Prostate enlargement with CAD,H.T.,Anemia and renal failure.You'll need a hemodialysis,till your renal function,electrolytes and anemia are stable. You'll be advised to have maintainence dialysis, 2-3 per week.A low salt,low protein,restricted fluid intake is standard advise given.Regular check-up with tests of Hb,creatinine,electrolytes and B.P.is a must.If you want my expert opinion,send all reports,as a direct question to me.Dr.Matthew J. Mangat. </s>

<s>[INST] My friend is having fleeting nausea. It is moderately intense: he sweats and feels as if he is going to vomit. Vomiting has occurred on a few occasions. He said that he feels better when he eats something: the nausea seems to go away almost instantly. Please point me in a general direction to assist him in his symptoms until he can get an appointment date with his primary care physician. Thank you so much! [/INST] Hi,Thanks for writing in.If your friend is having symptoms of nausea and sweating which shows improvement on eating then conditions like low blood glucose and anxiety related stress are to be investigated in detail. What happens is there is a possibility of the blood sugar level going down to sub normal and then this causes decreased glucose metabolism in the brain and other organs. While slight low glucose in blood might be tolerated for a short time, longer durations of hypoglycemia can cause dizziness, weakness, nausea and sweating. It is important to eat well and take adequate amount of nutritious foods rich in vitamins and proteins. If his food intake is normal then he should get investigated for any malabsorption syndrome due to which there is less amount of glucose entering his system. He should also relax and stay stress free and have small meals at short intervals. </s>

<s>[INST] I am 30 weeks pregnant and was just diagnosed with perianal abscess for the first time in my life. The doctor did not drain the abscess and I was just put on a course of anti-biotics for 10 days. Will I be ok with this treatment? Will the problem reoccur? [/INST] Hi dear, I have gone through your question and understand your concerns.If the perianal abscess is small, then it can be treated by antibiotics.However, if it is large and extensive, involving more of the perianal area, then the drainage should be done.Hope you found the answer helpful.Wishing you good health.Dr Deepti Verma </s>

<s>[INST] Hello doctor, I am a 36-year-old woman and I take Paxil for OCD, 40 mg a day. When I went off the medicines several years ago, I had a long period of time before I had symptoms again, but then they did return. So after some time, I began the Paxil again. I had been very slowly weaning off and I had been taking 7 mg or less per day for five months before I noticed any problems. Before that, I was taking about 14 mg per day for another five months. Is that normal? I mean it makes me wonder if I really need the medication because I had a long time on a low dose or none at all without symptoms. [/INST] Hi. Medicines are prescribed in little high doses to quell the acute symptoms and then maintenance doses to maintain the minimum threshold. Weaning off is to maintain the satisfactory threshold and to stop. But in the majority of the cases, weaning off or rather the whole process of treatment should be augmented with psychotherapies associated with the diagnosed condition. In your case, CBT (cognitive behavior therapy) should be augmented with the medicine. Combining medicines with CBT provides the brain with the much-required equilibrium and help maintain the chemical balance. Thus, when you wean off the medicine, the natural threshold can be maintained without medicine and with CBT. Talk to your psychiatrist or therapist regarding the procedure. Take care. </s>

<s>[INST] right now i m just fed of my life i don t know what to do... i just wanna achieve everything in life but without taking any risk....these days i m little bit disturbed..... i want to be an A+ grade student but nable to do that.......i even love a girl but never ever had the courage to walk up to her and ask her......please doc please do help me i m in great need of your help......!!!! [/INST] Hello dear. Your problem is very common of teenage. Dont worry go for some counselling sessions to builtup confidence. Dont be upset try to live stressfree life. Grade doesnt matter to become successful in life. Never loose hope. I never got A grade in my school. But still i am performing better than my A grade collegues. Go front of your girl and say whatever you want to say. Never keep in mind as when time goes it never comes back. You can take help of some antidepressants like escitalopram. So dont worry. Hope my suggestions helpful and thankful to you. Take care. And sont forget to give five stars. </s>

<s>[INST] I ve been told I have a belly button hernia and another to the right of it. My Dr. said the one on the right is not likely to cause a problem. I m feeling pain and extension in that area as well as above the belly button. Could it be something else flaring? [/INST] hi,thank-you for providing the brief history of you.As you have hernia this could be leading to pain as the inflammation could have arised.Undergoing physical therapy should help you. a hernia is bulging of an organ or tissue through an abnormal opening.So to correct the muscle patterns there will help reduce the hernia tissue. Also the pain will subside.In my clinical practice most cases with hernia respond well to physical therapy and doesn't need surgery.Regards Jay Indravadan Patel </s>

<s>[INST] I've recently watched a documentary (what if cannabis cured cancer) and even read some medical newsletters on the beneficial effects of Marijuana on the human body, In the documentary they talked about the possibility of cannabis curing cancer, due to the cancer killing agent in THC cannabidiol (CBD) , just wanted to get your views on this topic [/INST] The research on this matter is highly controversial and I would say, in its incipient stage, Cannabis are not used to cure cancer but they are used for palliative care in cancer as they improve hunger and give a sense of wellbeing. Medicinal Marijuana has some modifications and is being studied under medical supervision for use in debilitating conditions like HIV and certain cancers.i hope this helps sir. Drugs are harmful to health when overceding their amount and that should never be forgotten.thank you </s>

<s>[INST] I had two four cell embryos transferred on day two which was four days ago. I have woken up very hungry each day since. Is this a sign of anything? I don t seem to feel different in any way. The embryos are from my partner who is 35, I am 38. She had 8 eggs collected we kept four and shared four with an anonymous recipient. Three of the four we kept were good for icsi but only two fertilised, these are the two i now have. Should I feel anything? [/INST] Hello there,I can understand your concern. The symptoms you are having of hunger do not suggest anything in particular. One may not feel any different after an embryo transfer. It will take about 2 weeks before a pregnancy test can confirm whether your embryos have stuck to the uterus lining. Till then wait and be calm. You cannot do much and you may not feel anything at all. Some women feel mild pulling pain in the lower abdomen but these are all non specific. So dont worry and relax. Wait for the pregnancy test and till then take the medicines that your treating gynaecologist has suggested. Hope this helps.All the best and take care. </s>

<s>[INST] My friend was bitten by a spider. He is experiencing a burning sensation in his hands, breaking out in a rash on his arms, feels his air way swelling and it is becoming hard to breath. We gave him a benedryl to help with the allergic syptoms he was having. All of his sypmtoms have ceased but, should we seek further medical help? [/INST] Hi,Some time some poisonous bite gives rise severe allergic reaction producing severe edema in throat leading to medical emergency.Now as all allergic symptoms ceased, nothing to worry.Continue Benadryl or Cetrizine for 2-3 days more.Ok and take care. </s>

<s>[INST] Hi ,my fathers age is now 77 years. He is facing frequent chest pain for which I have already consulted a cardiologist recently with ECO,ECG & Angiogram. As per test report doctor advised that there is 2 blockage with more than 90 % & need to undergo angioplasty with 2 stent at the earliest. Please advise if the same can be treated by medicine or surgery is the only option keeping in mind his age ?? [/INST] Hello,Considering his age as well best treatment is angioplasty, which is not a major procedure. However, he can be maintained in the medicines also provided he is responding adequately and symptom free. But this is inferior to angioplasty even at this age group and risk of heart attack and decreased heart function will be more with this. Hope this helps you and get back if you have any doubts. </s>

<s>[INST] Hello doctor, My friend aged 30 had two drops of phenol mistaking for milk. He vomited and had lot of salt water. Please advice for any side effect. [/INST] Hi. I want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. No, there is not much problem right now as he vomited and also had a lot of water. It is fine because it was only two drops. 2. We usually do not go for emesis (vomiting) for phenol poisoning cases. Because, it is a volatile compound and causes vapors entering the lungs through the airways. 3. As it was only two drops, I do not think it may cause much trouble. If he feels short of breath contact me back, otherwise fine. 1. He should avoid re-exposure. 2. Rule out if there is some sort of suicidal ideation due to depression or anxiety and take him to a psychiatrist for physical evaluation. For further follow up consult a general practitioner online.---> </s>

<s>[INST] My six year old son had fever 4 days ago and started to have loose motion 3 days ago and still going on and now he is getting red spots around face and hands. We have seen the doctor yesterday and given medicine for loose motion. Why there are red spots coming? please suggest. [/INST] Hi...I feel by what you quote he should be having a - Hand Foot Mouth disease. This is one viral illness among all other exanthemas which can cause fever followed by rash over palms and soles. It is a self-limiting disorder and itching can be really worrisome. I suggest you use any over the counter antihistamine if you have one with you now. You can use Hydroxyzine at 1-2mg/kg/dose (Maximum 10mg) every 6th to 8th hourly for 7 days. This can even cause some peeling of skin in the next 4-6 weeks and do not worry about it.Regards - Dr. Sumanth </s>

<s>[INST] i have recently given birth to a baby. during pregnancy i developed rashes on my arms (they dont itch). i had asked my gynae what i should do about it but she just asked me to wait and said they will subside on their own. but i am still little worried as it looks really bad! Can u suggest something? [/INST] Hi.As per your case history you are having allergic dermatitis.My treatment advice is – 1. Avoid using any new products like soap or perfume.2. Apply a mild antibiotic plus steroid cream like fusiderm-B cream twice daily on it.3. Take an antihistamine like levocetirizine for 7-10days .4. Other treatment options are oral steroid and hydroxyzine given only after consulting a dermatologist.Thanks.Dr.Harshit Bhachech.MBBS, DDVL. </s>

<s>[INST] For a week now I have had a gnawing, uncomfortable feeling in my stomach, especially after eating small amounts of food. This occurs maybe half hour or so after eating. Its pretty much been constantly there for the whole week. I stayed home after the first day because I thought I had a stomach flu, but it s continued all week. Nighttime is very uncomfortable. I had a meal replacement drink because I was afraid to eat a meal but the pain and fullness feeling still came shortly after. No matter how small amount of food or drink I have, the full feeling and sharp pain still occur. Can you help me? [/INST] Hi Most likely you are suffering from Acid Peptic Disoder. You need to take simple soft diet without spices. Antacid suspension/gel containing oxetacaine 10ml 4 times daily before taking food with Proton-pump inhibitors (PPIs)- omeprazole 20mg, pantoprazole 40mg, rabeprazole 20mg in the morning empty stomach will be helpful. If needed you can take extra dose of Proton-pump inhibitors in the evening empty stomach. Instead of Proton-pump inhibitors, you can take H2 receptor antagonists - renowned brand Ranitidine (common brand name Zantac by Glaxo) 150mg morning and evening empty stomach may be used. Regards Ranjit </s>

<s>[INST] i have divarication and a hurnia too im a single parent so i cannot avoid heavy lifting or pushing pushchair and picking my child up. my doctor has reffered me to physio therapy as a operation would leave a huge scar. its really painfull what can i do ? [/INST] Hi,Surgery is the only treatment in cases of hernia. Hope it helps. If you have any other question please do not hesitate to contact us.Regards,Dr. Atishay Bukharia </s>

<s>[INST] dear doctor, please what is the way forward for a 23 year old boy that has been diagonised of hypogonadism?. fsh low(6) lh high(23) testotesterone low(2.3) and prolactin level high(25). i have not noticed a significant change in my sex organ since i was small. i have being placed on parlodel since more than a year now but i havee not noticed difference. i am gaining fats all over my body always weak~, weak muscles; changes in body complexion. please i need your help. thanks for your concern [/INST] Hi, Parlodel is for a prolactic secreting growth in the brain. The prolactic would gnerally be very high. Mostly someone is going to need testosterone if the testosterone and the testosterone stimulating hormones are low. Surgery fixes prolactin-secreting growths but a head scan would be needed to see it. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Matt Wachsman, Addiction Medicine Specialist </s>

<s>[INST] Hi I found out I was pregnant just after Christmas on 1st jan I started bleeding went to my doctor who really wasn t bothered didn t even examine me. I then referred myself to an epu for a scan where baby was seen with strong heartbeat and measured 8 weeks 1 day. Radiographer found no reason for bleeding. I continued to bleed and saw 3 different doctors all as unhelpful as the first. On 14th jan started getting really bad cramps and heavy bleeding went to hospital and was told I had miscarried to let it pass naturally. A week later I feel more pregnant than I did before and am sure I can feel movements as this is my 3rd pregnancy. Pregnancy test is still strong positive could I still be pregnant [/INST] Hello,You are suffering from heavy vaginal bleeding with abdominal cramp in 8-10 wks pregnancy.As per USG report, fetal heart beat was good enough. So, there is possibility of threatened type of miscarriage where complete recovery is possible.If bleeding persists constantly, then you may need Micronised Progesterone Tab or Depot injection to prevent future miscarriage and support pregnancy. But it is not always 100% effective. Consult with your gynecologist for suggestive measures.Take folic acid supplements, protein rich diet, avoid long journey/heavy work, maintain personal hygiene, take complete bed rest. Be well and take care.For more consultation, you may visit on Soumen </s>

<s>[INST] Hi, I have been bitten by either mosquito or some type of bug behind my thigh just from sitting outside. The day the bits are still itchy and if I scratch them, they become all red and the itch it terrible. Can you tell me why they are still there the next day or two? Thank you. [/INST] We are looking at either mosquito or bed bug bites. Yes bed bugs also are in public places like chairs, sofas or bus seats. You can wash the area with soap and water as the alkalinity in soap will reduce the itching. Also applying calamine lotion to the area would help . You can take a cetrizine tablet too just once a day to reduce itchiness for 3 days.Thank you for your query. </s>

<s>[INST] I have pain in my chest, under my left breast, happens quite often, recently had an ekg, doctor said everything fine, could be just acid reflux; I have been under a lot of stress in the past year or so taking care of my mom; my primary doctor says life is tough, life goes on and to just deal with the stress [/INST] Hi thanks for contacting HCM...Yes acid reflux and gastritis can lead reffred chest pain....Avoid taking stress that can aggravate your condition...For stress you can try yoga and exercise daily...Psychiatric counselling session will also be helpful....If needed psychiatrist may prescribed you anxiolytic drugs.. .You can take omeprazole acidity ...Avoid excess spicy foods...Avoid smoking, alcohol , meat like irritants...Excess tea and coffee avoided...Drink lots of water.....Don't worry .Try to be tension free....If chest pain increasing consult physician for examination..Take care </s>

<s>[INST] Hello, I am a chronic patient of liver issue.Had a streak of jaundice for 4 yrs till 2004.Then the bilirubin level was under control.But from 8-10 months again the bilirubin level is raised and the SGOT & SGPT level also is raised pretty much.For your reference the total bilirubin is 3.2 ,SGOT is 236 and SGPT is 286. Can you please tell me what might be the reason. Thanks [/INST] Hello, Welcome on HCM. You must get Liver Function Test done and a thorough general examination so establish the cause of this much rise. You must come with more details of body symptoms to come to any conclusion for what to do according to symptoms and what you are suffering from. Good luck Thanks. </s>

<s>[INST] Hello doctor, My fiancee and I had unprotected sex a few days back, but I did not ejaculate inside her. Just to be on the safer side, we wanted to use the emergency contraceptive pill. But due to some restriction in the country where we live, Plan B or emergency contraceptive pills are not available. I read that Yasmin, which is used as a regular contraceptive pill can be used as an emergency contraceptive pill at a higher dosage. Can Yasmin be used as an emergency contraceptive pill? And at what dosage? [/INST] Hi. How are you doing? Yes, as you have heard, Yasmin can be used as an emergency pill. Even if you have not ejaculated into her, she stands a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact with her genitals. As soon as possible, earlier the better, I suggest taking four tablets of Yasmin (combination of Ethinyl Estradiol and Drospirenone) at the time, repeat four more tablets after 12 hours. This being a high dose of hormones, it will suddenly increase the inner lining of the uterus. Then as it is a single dose, the inner lining will fall off. This makes it unfavorable for the possible embryo or baby to settle into the uterus. She will get her periods within 7 to 10 days of the last pill. But do not keep repeating this frequently, it can disturb the hormonal balance and can reduce the effectiveness of the pill. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. This is an old method, but it is an effective emergency method. Just do not delay the pills. As time passes by, the effectiveness reduces. Hope I have clarified your query, do write back. All the best. For further queries consult an obstetrician and gynaecologist online --> </s>

<s>[INST] Hello doctor, This is a concern regarding my mom, whose mental health has become poor due to sort of negative thoughts after a year ago death of my dad. She is 51 years of age. I can seen her speaking to herself, hitting her head with her hands as something disturbing her brain, and lack of sleep. When asked, she is not expressing it in detail as she feels they are very bad evil thoughts and does not want to disturb us. She is restless even when lying down or sometimes at sleep. Please suggest me on what to do to relieve her from this state and make her happy. [/INST] Dear The symptoms corresponds to Post Grief Psychological Disorder. But it hadn't subsided for more than a year. Then it is a concern. Self talk, hitting head and lack of sleep - Note the frequency of these symptoms. Get to a psychiatrist with these details. Because this illness should not develop into psychoses. Wish her speedy recovery. </s>

<s>[INST] gd morning.my boy baby is 8 month.he is 8 kg.before 1 month suddenly his colour faded and now he is perfectly dark.i give ragi powder 4 times daily.am in UAE.very hot climate.now use jhonson and j baby oil in body and parachute oil in head.i changed soap and oil one month before.sebamed soap now before jhonson and j soap.is there any remedy?what are foods that can give fro this month?my sister told dont give ragi if too hot is the climate.really? [/INST] Hi, Thanks for writing to Healthcare magic.At outset I would like to know, what is the tone of your and your husbands colour?If both of you are from deeper tone of colour, then the child will also have similar tone. Seba med products can be continued. Please do refer to my article on weaning food for baby this helps you </s>

<s>[INST] hi! i am taking divalproex and oxycabamazepine for the past 5 months as i got depressed after a psycho deceived me in the name of marriage,now my weight is 5feet 4 and weight is 88kilos , age -38. I want to change medication as i feel dull and sedated at times,please help [/INST] Hello,Thanks for choosing health care magic for posting your query.I have gone through your question in detail and I can understand what you are going through.You have mentioned that you are depressed but unfortunately the medicines that you have mentioned doesn't have anti depressant in it. Both are primarily mood stabilizers. Along with the mood stabilizers you need to be on antidepressants as well. If sedation is a problem then you may choose bupropion or fluoxetine as antidepressants as they are nonsedative anti-depressants.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/dr-srikanth-reddy </s>

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

<s>[INST] Its clearly difficult for me to put things in words when I wake up every morning I forget Things. I feel fuzzy and confused. I feel tired and fatigued. Slowly and slowly I revive my self but there are times when I can t really recover and feel disconnected. I don t remember name at times. Its getting exceptionally complicated to write these days [/INST] hi dear,first of all what is your age and since when you have such complain?is there any medical illness you have like hypertension , diabetes etc.any history of head injury?without detail history one can not say anything.hows your mood and sleep and appetite pattern?consult psychiatrist Thank you </s>

<s>[INST] I was in a car accident also 2 months ago. I suffered a chest contusion that covered most of my right breast. I have noticed since the bruising has went away, I now have a large indentation on the breast. Do I need to be concern? With what I m read on the web, I m afraid that I met have breast cancer now. [/INST] Hello, Consult a general surgeon and plan for an ultrasound scan. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician </s>

<s>[INST] does the patch still be effective when it got very wrinkles and water gets into the wrinkles edge when showering? Would Miralax make the Evra patch less effective? I heard that if we have diarrhea while on the pill it would flush out the pill, but since the patch goes straight to the bloodstream, then does it mean I m still protected if throwing up or have diarrhea? Can I place the patch on my thigh in the back (under the buttock) and front? [/INST] the patch should be placed on your lower abdomen, chest (not breast), arm, upper back, or buttocks. the thigh is not one of the approved places, so it may not work.you are correct that since it is not absorbed in the digestive tract, that diarrhea and miralax will not change it's' effectiveness.as long as it is still sticking on your skin it will work, but if the water washes it off you should replace it.I hope this answers your question, please let me know if you have any more questions. </s>

<s>[INST] I'm 40 and have had Slight discomfort on left side of my chest, kind of a little pressure, actually felt like i may even stop breathing just for a couple seconds then everything went back to normal but i was so tired and no energy after this episode....What could this have been...actually twice this has happened over last few weeks [/INST] Thanks for your question on Healthcare Magic. I can understand your concern. In my opinion, we should first rule out heart related diseases because left sided chest discomfort is commonly seen with heart diseases. So get done ecg and 2d echo. If both these are normal then no need to worry for heart diseases. Sometimes, stress and anxiety can also cause similar kind of chest pressure and left sided chest pain. So better to consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on it's solution. You may need anxiolytic drugs too. Don't worry, you will be alright. Avoid stress and tension, be relax and calm. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. </s>