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<s>[INST] Daughter has akathesia caused by reglan and compozine. This has been on going for one month. it has caused disassociation, anxiety, memory loss, tremors, out bursts of anger. looking for help on how to treat her. quality of life poor, never had issues until those meds were given. [/INST] Hi,Thanks for choosing Healthcaremagic.I have read your query carefully and understood that your daughter had taken Reglan (Metoclopramide) and Compazine (Prochlorperazine) (??Dose and duration) and now she is having symptoms suggestive of akathisia since last one month. I would like to let you know that both the drugs are dopamine antagonist and are commonly used for nausea and vomiting. And akathisia is a rare side effect of both of them. It can be treated with B-blockers (like propranolol 20-40mg/day) and a benzodiazepine (like clonazepam 0.5-1mg/day).But the patient needs to be evaluated by a psychiatrist before starting those medications to identify the cause for its onset in the patient and the cause for its prolonged duration of side effect.Hope I answered your query, let me know if you need any further information.RegardsDR. ASHUTOSH SINGH </s>

<s>[INST] Hi. My daughter, 18, began not feeling well on Tuesday. She was achy & tired. On Wednesday morning she woke up with puffy eyelids & still not did not feel well. On Thursday, eyes still puffy, body aches, and she had a mild fever of 99-100, & then it went up to 102 in the evening. Same symptoms remained on Friday with fever remaining between 99-100 when using tylenol. I took her to the Dr. on Friday. Dr. wasn t sure what she had - something viral? Flu? NO blood work was taken. Although we are not aware of any tick bite (we are in a high tick area), we discussed the possibility of the tick disease, anaplasmosis because 2 of our close neighbors were recently diagnosed. Dr. suggested waiting things out through the weekend to see how she did and wrote us a script for Doxycycline and left if up to us on whether we wanted to start it. Fever went up to 102 again on Fri. night. Saturday morning we gave her 1 doxycycline & tylenol. Thoughout the day, fever averaged about 100.6 then went to 101+ during the night. Before bed we gave her a 2nd dose of the Doxyclycline which she threw up within just a few minutes of taking. Eyes seem to get more puffy the higher the fever. After throwing up the Doxyclycline, we did not give it to her again and have continued with tylenol or ibuprofen to try to keep the fever down. Tonight follows the same pattern, fever up, body aches worse (legs feel crawly to her at times), & eyes more puffy again. Cool compresses do not bring down the puffiness of eyes. We re not sure what to do next. Start her back on Doxy, take her in tomorrow for blood work? She is visibly uncomfortable. She has also had a decreased appetite. At times, in addition to the puffy eyes, her face looks somewhat swollen. No sore throat but some swollen glands in neck. Please help. Thank you [/INST] Hello,her symptoms seem a lot like influenza although other illnesses (viral or bacterial) could have caused the same symptoms. Since there are not many symptoms to guide the diagnostic procedure, you've got the choice to wait and see or to do some tests. Some useful tests include the complete blood count and the c-reactive protein (CRP). Increased white blood cells (with polymorphonuclear predomination) and high values of CRP likely indicate bacterial disease which needs antibiotic treatment. Low CRP values usually accompany viral illnesses although none of the above is 100% error-free. Worrisome symptoms and signs include faintness or orthostatic hypotension, very high pulse rate, decreased urine output, shortness of breath, too many breaths/minute and decreased cognitive functions. I hope I've been clear enough, without too much medical jargon.I'll be glad to provide further clarifications though, if you're still left with questions.Kind Regards! </s>

<s>[INST] Hello doctor,I have had fistula two years ago. It healed without surgery, but now it has again developed with the release of pus. I am taking ayurvedic tablets. [/INST] Hello. An anorectal fistula is an abnormal channel from the anus or rectum usually to the skin near the anus. A fistula may be painful and discharge pus. We can determine its direction by inserting the probe. Sometimes it is healed with proper medications and changed lifestyle. But if its root (fibrosed tissues) remain inside the sinuses, then it recurs due to changes in food habits and lifestyles. Ksharasutra ligation treatment is the best option to treat it. Treatment plan: Now you are taking good medicines to this concern. You can add Amrita Bhallataka one teaspoon twice a day after meals. But the ultimate treatment is Ksharasutra ligation treatment. For more information consult an ayurveda specialist online --> </s>

<s>[INST] i just started taking birth control . i was told by my doctor to take it the third day after my period started because the last few days are very light. Anyways, now that i am about 15 -16 days into taking the birth control, i have period like symptoms, and the flow is like the first day of my regular period...... do you get your period twice during the first month of taking the birth control pill ? (taking alesse ) [/INST] Hello, I would be happy to help you with your question. This is not typical for a birth control pill start. It might be related to irregularity in your cycle that existed before your started the pill. I really cannot tell based on the limited information provided. In your case, I would recommend: 1. Check a pregnancy test 2. Continue taking the pill daily 3. Expect that things will regulate over the next 1-2 months 4. If this does not help, then talk to your doctor about a different pill I hope that this helps and good luck!! </s>

<s>[INST] I have recently discovered a little lump under my armpit and it hurts to the touch, its not hard on the surface its more like a pimple but when i press it it gets hard it hurts when i move my arm I dont know what is it Im gonna get it checked tomorrow I am so worried though [/INST] Respected user , HiWelcome to Healthcaremagic.comI have gone through your concern in depth .* This seems inflammatory condition involving subcutaneous space may be sebaceous cyst , boil or else .* Need clinical confirmation with examination or evaluation with high resolution photo pic as an attachment .Hope this will help you for sure .Wishing you fine recovery from the same .Regards . </s>

<s>[INST] I am 26 years old .I am suffering from stomach problem since last 3 years. I have gone through all types of test.but all reports are clear expect there may be some swelling inside.I have been living in pain since 3 years.I get aroused from 1 years old .I use to masturbate. i develop habit of doing this activity.Are there any chances that,by doing so I have damaged some thing internally.and that is not being diagnosed.?My friend told me that it may be due to damage of urine bladder sphincter.I f so please suggest me some medicines or some thing to solve this problem.This is such a cheap activity that I cannot tell to gastroenterologist that I used to visit.IF THERE IS SOME MEDICINES OR TABLETS AVAILABLE PLEASE RECOMMEND ME.PLEASE HELP ME OUT. [/INST] Hello, Masturbation can't cause such an issue. There is nothing wrong in masturbation, more than 90% of men does that. You can masturbate twice a week with out any issue. Symptoms of chronic masturbation can be due to nutritarian issue. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr S.R.Raveendran, Sexologist </s>

<s>[INST] I received a bullet to my head in the late 80 s entrance wound was on the right side and exited through left ear causing damage to artery. Day before yesterday I started getting large bump on my forehead going from hairline to a fingers width of eyebrow. I have swelling around eye as well as redness to th area described above. Today I m having vision problems with my right eye and I also have bump under the skin by my r ear about the size of my little finger. Both hurts to apply pressure. Would there be any case of bullet fragments moving? [/INST] Hi, thanks for sharing your health concerns with HCM! As per your description, this is a medical emergency and you should consult ER urgently! There must be some internal bleeding, whatever might be the cause; may be some ruptured aneurysm/hematoma etc. but needs immediate CT scan of brain for assessment and opinion by a neuroradiologist / neurosurgeon.Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health. </s>

<s>[INST] I have been diagnosed with Graves disease and am on medication for my heart rate and for my thyroid. I have been experiencing rapid heart rate heavy chest problems breathing and it feels like my heart is beating really fast and then kinda stops for a couple of beats then starts with the rapid beating again [/INST] Hello I am Dr.Sadaf and i just read your query.you have Graves disease which is a immune thyroid disorder which produces an excess of thyroid hormone. Thyroid hormones affect the body systems and cause various signs and symptoms and one of them is rapid heart rate as your have mentioned.I would suggest that you see a local doctor if you have irregular heart rate and do an ECG.Typically you must receive medicines for thyroid disease and for your rapid heart rate and if that doesn't help then you must get reassessed for further advanced invasive methods if necessary.I hope that helps resolve your query. </s>

<s>[INST] My son has a lump on the side of his neck that is very close to his jaw line where his jaw meets his ear, about one inch in diameter, pink in color, hard composition, and painful to the touch. Any ideas as to what this might be? My son has no known allergies but did have dental x-rays this morning for the first time. Could this be a reaction to the radiation? [/INST] Hi,Welcome to HCM.This could be Mumps Parotitis with preauricular lump in your sons neck just closeto the jawline,as its painful and hard.This is not a reaction to the dental x-ray which your son had.Other possiblities need Second opinion from a Surgeon.I would hence suggest to Consult a Surgeon and if need be decompress the painful lump.Hope this would help you to resolve your query.Else Contact with a Followup Premium question to ME.Will appreciate your Hitting thanks and writing excellent review comments to help needy patients like you. Welcome with any other further query in this regard.Good Day!!Dr.Savaskar,Senior Surgical SpecialistM.S.Genl-CVTS </s>

<s>[INST] hi doctor, my name is jake thomas i am from arlington texas and im kinda worried because i have had a cough for over 2 weeks but i dont feel sick and i dont know whats going on so im getting kinda scared. i dont know if its from my smoking/cancer or what not. [/INST] Since you are having cough for 2 weeks and you are a smoker i will suggest u take antibiotic tab augmentin 625 mg thrice daily after food for 7 days.U can also take syrup mits codeine linctus 2 tsf thrice daily for 5 days.If cough still persist then do chest x ray PA view.If any shadow is found in chest x ray do CT scan of chest with contrast.RegardsDr De </s>

<s>[INST] Hello, I'm 19, skinny, and a smoker. For the past month I've have trouble going to sleep because of chest pain and random tingly feelings in my left arm and leg. With the occasionally pressure headache. Early I experienced a strong time stopping pain in my chest and about 5mins later it felt like a bubble burst, then my leg went numb. Any help thanks. [/INST] Thanks for your question on Healthcare Magic.I can understand your concern. Since you are smoker, you are at risk of heart diseases. So we should first rule out heart diseases for your symptoms. So get done ecg, 2d echo and stress test. If all these are normal then no need to worry for heart diseases. Sometimes stress and tension can also cause similar symptoms. So avoid stress and tension, be relax and calm. Quit smoking as soon as possible as this is not a good habit. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. </s>

<s>[INST] I am an amputee and have been so quite a long time. My problem is severe pain in the stump. On a scale of 1to10 it is a 10. These pains come on rather quickly about every few months and last at least a day. The pains come on every few minutes and last 10 or 15 seconds. The are very severe. I have talked to my Doctors about it but never a satisfied answer. I desperate and hope you can help. Thank you, Bobby [/INST] quite a lot. Any 'nerve pill' is likely to work:lidocaine patchanti-epileptics such as gabapentinamitryptilineand many others. A neurologist or pain managment physician, heck a regular doc too, should be able to treat this without need of narcotics. </s>

<s>[INST] my son has some lump below his toe he feel some stretching doctor told it is a kind of isap his blood report shows llittle less hemoglobin i.e 12 and increase in eosinophil kindly advice me his age is 16 years and this is occured 5 months back but till today he is not fully cured [/INST] HI,Luke,Dear,Thanks for the query to HCM.1-I have studied your query in depth.2-DEar,IN my opinion, the lump below toe with reaised eosinophil increase in 16 yr son with 12 hb,unhealed since 5 mths,may be Eosinophil granuloma of the foot pad,with stretching feel.3-Treatment could be planned by ortho-paedic surgeon for the foot pad lump-or by the general physician who would correlate and treat the anaemia associated with eosinophilia.3-a-Empirical treatment-to control mycoplasma infection -with doxy-200 mg ,to take care of chronic infection,3-b-Diclofenac-treats to reduce local lumpy growth,3-c-Anti-eosinophilic drug treats-by physician doctor,would take care of the worries you had for your sons lump below the toe.3-d-Treatments-would be decided by a ortho-Surgeon-for the lumps below the toe,after foot X-ray studies in various planes.4-Hope this would solve your query to your satisfaction.5-Wellcome for more queries to me On HCM.6-Thnks once again for your inquisitive query.Have a Good Day..!! </s>

<s>[INST] i am having afib and erratic heart rhythums, shortness of breath, weakness in muscles, now im having trouble eating. how long do you go before going to er. last time they gave me a few carvediol and said there was nothing for them to do but they never stabilzed the heart rhythum. [/INST] Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. Beta blockers intake may can cause decreased appetite. You have to rule out what is the cause for atrial fibrillation? Is it structural heart disease or vascular problem or electrolyte imbalance etc?? Hope I have answered your query. Let me know if I can assist you further. </s>

<s>[INST] I have had an ultrasound and an endoscopy to determine what my stomach issues are. I suffer from diarrhea and stomach pain and I have a hard or firm section just below my sternum. My doctor says there is nothing wrong that he can find, but I am still troubled by this to the point of not eating b/c I never know how it will impact me. Also, the skin on my stomach is always cold regardless of what I am doing. Even if I wrap my stomach and exercise my skin is always cold. [/INST] Hello..As per your narration, more chances are that you are suffering from irritable bowel syndrome. This problem aggregates if one constantly keeps thinking about hi/her disease and takes undue stress. Please correct your diarrhea first and if your ultrasound is normal ,dont think much. Take cap racecadotril OD for five days , you will be all fine . Get tour thyroid profile done to look for your cold skin causes. </s>

<s>[INST] My 10 month old baby was diagnosed with throat infection 9 days back. Now her cold has worsened her voice is hoarse and her tongue has a greenish patch at the back closer to her throat. She screams a lot last 2 days and it is clear it is bothering her. What could it be? I am still breastfeeding my baby. [/INST] HiWelcome to Health care Magic.Green patch on the throat indicates infection. This requires treatment by the use of antibiotics and anti-inflammatory drugs.Hence I advice you to consult your doctor for further treatment.Hope this is helpful to you.Please do write back to me for further questions.Thank you </s>

<s>[INST] Yes... I had a liver enzyme test on June 14th which indicated: ALP 179 ALT 72 AST 68 then I had another test on August 21st which indicated: ALP 174 ALT 55 AST 56 Apparently my liver enzymes have been high since last year. I have Multiple Sclerosis and have been injecting with copaxone for 15 years. Since copaxone is a man made drug I am under the impression that would not elevate liver enzymes. My MS Neuro does not think my other meds are causing any problems. Two family members (on my mother s side) died from liver cancer . My Aunt was 60 and my Grandfather was 80. This is my question: should I pursue additional testing. Symptoms: dark circles under eyes, rough brown bumby rash on upper legs, veins popping out of my hands, feeling sick to stomach during and after meals, bloated belly and a feeling of something is larger on the right upper chest area. My MS Neuro ordered a ultrasound: Impression: 1) No evidence of cholelithiasis or cholecystitis , 2) there was not pain focal to the gallbladder however pain was noted in the right ribs during exam, 3) technicially difficult exam secondary to bowel gas. A probable hepatic hemangloma and cyst noted on prior CT examinations were not visualized. Was never told about #3. [/INST] Hi, Thank you for contacting Healthcare Magic. You have elevated liver enzymes, which has been confirmed on two occasions, but as per your description, they have been high for over a year. As you corrected suspected, copaxone (glatiramer acetate) used for treating multiple sclerosis (MS), does not lead to elevated liver enzymes. MS per se is a disease of central nervous system (affecting brain, spinal cord and optic nerves); liver is not affected in MS. In view of a positive family history of liver cancer, you possibly should further pusue the abnormality in liver function tests. However, based on Ultrasound exam, your liver is absolutely normal and it is a great relief. Best wishes, Dr Sudhir Kumar MD DM (Neurology) Senior Consultant Neurologist Apollo Health City, Hyderabad </s>

<s>[INST] sir ,recently my mother have breathing problems and she is admitted in a hospitle in my city kerala .during investigTION BY CARDIO GRAPH it was found that the mv calcified and thickned and showing subvalvular apparatus fused . now she i having medicine prescribed by the doctor and she is all right .what is the treatment for this and how much it will cost [/INST] Thanks for your question on Healthcare Magic.I can understand your concern. I have gone through the 2d echo you have mentioned.It is showing age related changes in mitral valve. So if she is doing good with medicines then no need to go for surgery. Surgery (mitral valve replacement) will cost you around 1.5 lakhs.But it is indicated only in patient when conservative treatment (medicines) does not work.Hope I have solved your query. I will be happy to help you further. Wishing good health to your mother. Thanks. </s>

<s>[INST] i have been experiencing pain in my upper back the last few days whenever i take a deep breath. I thought maybe i had injured my back, but have had no situations that would have caused an injury. I feels more internal than muscuar.Now it seems to be even in my lower back. I noticed that as the temperature is colder outside, it hurts more when i breath in the cold air. it this possibly something to do with my lungs and not my back?advice?thanks,Alex [/INST] Hi AlexYou may consult a physician initially who can examine and determine which is implicated,back or lungs,pleura(covering) of lungs..Take Tylenol tabs,avoid bendsand try observing whether coughing ,sneezing increase pain..Report to doctor.also record any temperature or fever or any other symptom like acidity, burning in stomach,bloating,based or flatulence.take precautionary pantaprazole 20 empty stomach in morning once daily </s>

<s>[INST] Hi, I am Jessica. I have been experiencing sever low back hip pain for a week. It s getting worsse. Hard to walk. My neuro called yesterday with my blood results. Eerything was good, but high potassium. I went to y family doc tyoday, and was told i Have a bladder infection? Sounds to me more like kidney stones?? [/INST] helloThanks for query .Severe low back pain without any positive neurological findings is most likely to be due to presence of stone either in kidney or Ureter.Please consult qualified Urologist for clinical and digital rectal examination and get following basic tests done to confirm the diagnosis.1) Urine routine and culture.2) Ultrasound scanning of abdomen and pelvis3) Serum electrolytes Further treatment will depend upon result of these tests and final diagnosis.Dr.Patil. . </s>

<s>[INST] I am having a fluttering bubbling feeling in my calves - mostly right one and sometimes lower left inside. I am worried it is a blood clot or something terrible. Symptoms have shown up for the last month or so maybe 2. I jog 2 miles, three times a week. I smoke a pack a day. I currently take high blood pressure medication (low dose) and fluid pill. It is a weird feeling like I can feel something twitching in there. It is basically a twitchy, bubbling, fluttery feeling in calves. Can you advise please? [/INST] Hello,The most common cause of a twitching calf muscle is a nerve irritation in the back. Typically, this nerve irritation occurs due to a disc issue or inflammation from arthritis putting pressure on the nerve. So to stop the twitching caused by an irritated nerve, the nerve must be treated. I suggest using anti inflammatory medications such as Acetaminophen to relieve the twitching. If the symptoms continue, I suggest to see a neurologist.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Dorina Gurabardhi, General & Family Physician </s>

<s>[INST] I am 50 years old had Ct scan and us found cyst in left kidney tingling and numbness in both legs down to toes weak tired cant even fold a load of clothes let alone walk without assistance. Please help getting no help from doctors. One says orthopedic another says endocrinoligst another says nephroligist [/INST] Hi,Thanks for asking.Based on your query, my opinion is as follows.1. Cyst size in left kidney is important for management. If small, it can be safely ignored.2. Tingling and numbness is possibly due to diabetic neuropathy or Vit B12 deficiency.3. Meet a neurologist to identify possible cause. If you have any back pain, Ct scan may be necessary. Continue treatment with Vit B12 and lipoic acid. It could show improvement within two weeks.Hope it helps.Any further queries, happy to help again. </s>

<s>[INST] I keep feeling sick to my stomach, tired, cranky, and I feel just like i did when I was pregnant with my son. During that pregnancy, I had a blood test done at about 9 weeks and it was negative...I went to my doc and he did an ultrasound and found a heartbeat. Should I trust the blood test I took or should I get an ultrasound done. My lasy normal period was nov. 22. The 13 of dec i had about half a pad of blood then nothing...? [/INST] Hello,Thank You for the query at HealthcareMagicQuantitative blood HCG levels are very accurate (more than 97%). But sometimes false negative results are possible,if testing is done very early in pregnancy.Since you haven't had menstrual cycle since last December, I'd recommend to repeat blood HCG levels. If it still comes back negative, Vaginal Ultrasound can confirm the presence/ absence of pregnancy and fetal viability .Hope I was able to help youPlease address any more concernsRegards,Dr.Lekshmi </s>

<s>[INST] Hi doctor, I am having intense pain in my lower wisdom tooth that is making my neck, shoulder, and head hurt badly. This just started up around 6 PM today. I have been taking Ibuprofen, but nothing is working. Please help. [/INST] Hi. For further information consult a dentist online --> </s>

<s>[INST] My 3 week old has been having problems with his formula so they changed it to soy. Now he throws up, it comes out of his nose at times & he gets choked a lot. I ve also noticed he seems to be developing a cold, sneezing, coughing, & sucking yellow mucous out of his nose. He also has began to keep bubbly spit around his mouth. Does this all sound like a problem developing or all sound normal? [/INST] Hello... I ve reviewed your question... Now regurgitation of feed from mouth and nose two to three times a day is a normal phenomenon provided baby is feeding well, gaining weight and passes adequate urine... sneezing and mucus are mainly due to weather changes and simple normal saline nasal drops are useful... but if baby is not taking feeds well or she is losing weight or she is having breathing difficulty than you have to consult pediatrician earliest.... hope my answer will help you... thank you... have a healthy day </s>

<s>[INST] Hi, I am a 36yr old female of normal weight and no history of medical problems other than fiberous breast tissue. I seem to have a chronic sinus infection (Have suffered with sinus on and off for years) for last two weeks and a week ago I noticed a pea sized movable lump on the right side of my neck near my collarbone. I have since found another one right beside it. The lumps are painless but when i bend over I feel pressure all across the sinus area of my face and also a bit in my neck. Please advise, am terrified of cancer. [/INST] welcome to Health care magic.1.Lump on the neck are generally due to infections / inflammations / underlying medical conditions .2.The breast lesion need to be confirmed with an ultrasound.3.Suggest you get an ultrasound neck done, it will help to find out the origin and extensions of the lesion.4.Please get an appointment and get the needful investigations done.Hope it helps you. Wish you a good health.Anything to ask ? do not hesitate. Thank you. </s>

<s>[INST] Hi doctor, I am a 28-year-old male, approximately 93 kg, 1.89 cm. Over the past year, I have been getting muscle fasciculations on in my calves (mainly) and also in my quads. I have seen several doctors now and they have checked my reflexes and feeling in my legs and it is all fine. The fasiculations occur, or get worse when I do weights that strain the back of my neck, where it meets the base of my skull. For example shoulder press, or bench press. I have proven that this is the problem many times now. Caffine, alcohol, etc., are all stimulants that make it worse. However, the weights I mentioned above I am certain is the problem. The fasiculations are bad, I have had countless sleepless nights because the twitching is so bad. It is important that I find the problem as I do not want to stop weights permanently. I requested my doctor to prescribe me with blocker drugs and he has given me Gabapentin Milpharm 300 mg. These actually help and reduce the fasiculations. I also went to a chiropractor who was excellent in helping my mobility through my neck and back but could not stop the twitching. He said that I need to see a Neurologist. Does anyone know what is wrong with me? Or what I should do from here? [/INST] Hi. Involuntarily muscle twitching or fasciculations could result from various causes. Most common being anxiety, hyperthyroidism, nerve compression at lower back, restless leg syndrome, vitamin B12 deficiency, vitamin D deficiency. If we think of uncommon causes, they could be amyotrophic lateral sclerosis or multiple sclerosis. In my opinion, you need a comprehensive workup first. That includes thyroid profile, vitamin D and B12 levels, blood counts, MRI LS spine, EEG. So, you do not need to rush to a neurologist. First of all, go to your GP. Request him for these tests. Let the report come and then you can go for a neurology opinion. My recommendations in such cases for treatment would be taking Mecobalamineshots, Vitamin D and Calcium supplements. You can also ask your doctor to prescribe you Pregabalin in sustained release form for at least three months. </s>

<s>[INST] Hello doctor, I have a horizontal black line on my nose from the past seven years. During the time of menses, it looks lighter, but on the other days, it looks darker. I applied everything from lemon juice, potato juice, cucumber, kojic cream, etc. But nothing works. What should I do? [/INST] Hello. This will help you hopefully. for more information consult a dermatologist online --> </s>

<s>[INST] A few months ago my tooth broke off (molar) I went to dentist and had it filled... He said it was deep and I may eventually need a root canal . About 4 weeks later I start having ear pain, face pain... Headaches so I went back to the dentist and he prescribed a zpack last week... Since then I have gone back and he started the root canal... But last several days my chest feels heavy. Kinda shortness of breath. Not wheezy and no fever. Should I be concerned? [/INST] hi as per the information provided by you the symptoms of your chest have nothing to do with the dental procedure you have undergone. had it been some allergic reaction to the procedure or medication taken for the procedure the chest symptoms should have appeared earlier. so unless you feel the shortness of breath or fatigue for another 1 week you should nt worry otherwise see a general physician and tell about your symptoms. take care . </s>

<s>[INST] Hi, I woke up this morning with a bad stomach ache (never get them). Felt the need for a number 2 many times today but when I do I get a big pain in my testicular area. It seems to not the be testicles themselves but above them in the sack, mainly on the right hand side I found. I have been sick twice today without actually feeling ill (other than the stomach pains). Still the same 12 hours later. Please advise, thanks. [/INST] Hi, Looks like you are suffering from acute intestinal infection with pain you are describing could possibly an fissure which can develop in presence of diarrhoea. can take a mild antispasmodic and a probiotic available otc to relieve the symptoms if not better worthwhile seeing a physician. wish you a speedy recovery. </s>

<s>[INST] I have had pretty severe jaw pain for over a week. I've been to dentist- all is fine with my teeth. though there are signs of grinding. Been to fam prac Dr. He said it's prob TMJ- been to massage therapist- that seemed to help for a day--been to chiropractor twice--had back, neck and jaw adjusted. Didn't seem to help. Now, I'm feeling nauseous. I'm dizzy and my jaw hurts. [/INST] Hi dear ,Welcome to HCM,Understanding your concern .As per your query you have jaw pain after recent root canal therapy . The symptoms you mention in quoery are probably occur due to high point that remain after treatment . Due to high point your temporomandibular joint ( TMJ) causing problem and because of arthritis things got further complivated . I would suggest you to consult dentist again for proper examination . Doctor may order x-ray torule out causes like bruxism , dental infection and other TMJ problems . Doctor may relieve the high point , give night guard and may prescribe further antibiotic course . For now try to eat soft or take liquid diet and do not open you mouth wide . Doctor may also refer you to gastroenterologist for nausea .Hope your concern has been resolved.Get Well Soon.Best Wishes,Dr. Harry Maheshwari </s>

<s>[INST] Hi doctor, I am 27 years old, and I have an embarrassing problem with my penis. The opening of my penis, from where the urine comes out is not at the tip, and it is slightly lower. I am still a virgin. Will it be a problem for my sex life? Is it a major problem? [/INST] Hello. Good that you have come out with your issue. If there is a cosmetic concern, then you may get it corrected. But I can comment on the overall scenario only after looking at the picture. Revert with more information to a urologist online --> </s>

<s>[INST] I have already been diagnosed with vertigo and presently on 100mg of neurotin. I thought I was in remission from the dizzies and vomiting, but the dizzies have returned so severely that I can't walk across a parking lot or to my car without assistance. This is causing me a lot of grief since I am I am a Senior Fitness Exercise Teacher, and I now I have to teach from the chair. I can't stand the sympathy or asking for help. Any answers. I have already had all the tests to prove vertigo.. [/INST] Hi,Thank you for posting your query.Based on your description, the most likely cause of your symptoms could be BPPV-benign paroxysmal positional vertigo. An evaluation by a neuro-otologist would help in confirming the diagnosis and planning the treatment. Tests may include audiometry, electronystagmography (ENG) and vestibular function tests.Treatment consists of medications such as piracetam, vitamin B12 and betahistine tablets. In addition, vestibular adaptation exercises are also helpful.I hope it helps.Please get back if you require any additional information.Best wishes,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad,My personal URL on this website: My blog: </s>

<s>[INST] After sex i have terrible pain its like mini contractions (have coil not pregnant) could my coil have moved therefore causing me pain paracetmol does nothing. The pain is unbearable and the day after my body aches it lasted about 4 hours nd the pain went round to my back of [/INST] HIThank for asking to HCMI really appreciate your concern and looking to the history given here I could say that if there is some device in uterine cavity then this need to be removed first and have Tab Ibuprofen 400 mg three times in day and Tab Cefdinire 300 mg twice in day for 5 days the chances of vaginitis is likely and antibiotic may be needed, have a nice day. </s>

<s>[INST] Hi i am prasad 28 yr male I have indigestion problem Doctor said it is IBS but as soon as i eat my meals i feel iritating bloating and after 2 hrs acidity so i dont think it is IBS I want to confirm that is this really IBS or some other problem like anemia I feel tied and night mars always. I can find undigested food in my stool. I started to take iron tablets From 2 days. Is it helps me to solve my problem ? How many days need to affect iron tablets ? Please answer my question in detail. [/INST] Hi Welcome to Healthcare magic Forum The symptoms suggest that its IBS. IBS or chronic indigestion or Acid Peptic Disorder can make a person anemic, as iron may not be absorbed, or food intake may not be sufficient. 2 days is not enough for iron tablets to act, it will take months to increase your Hb level. (You havnet mentioned how much is it at the moment). Correnting the underlying condition is necessary, as even if you take iron/iron rich food or any supplements, they may not be absorbed by the body . You can take homeopathy safely for IBS. Takecare </s>

<s>[INST] My Uncle who is about 65 years old living in Sri Lanka has a pressure drop to less than 60 when he gets up after being seated and then he falls.The Doctors there have been sending him from pillar to post for allmost one year now and his condition has worsened.We have decided to bring him to India.A MRI too was done about three months ago. Also the Doctors there say he is not responding to Frudro Cortizon.What ever that means! Please help us Doctore so that we can bring him there tpo Bombay. Regrads Milindha my e mail is YYYY@YYYY [/INST] dear mam. he needs a thorough examination to find out the cause. his BP levels to be monitored 3 to 4 times a day n recorded.his cardiac function also need to be checked by ecg and echo. following which CT scan of the brain r MRI needs to be correlated with the clinical symptoms, BP and sugar levels. by doing these v can arrive at diagnosis. one more cause is postural hypotension. this also to be kept in mind while doing diagnosis. if his bp s high r low r fluctuating. ultrasound of the abdomen to be also done to find the cause. after the diagnosis s done. treatment can be given. thank u </s>

<s>[INST] My grand mother is a known case f htn nd hypercholesterl recenty she develop imbalance while walkng nd weakness. N her MRI report shows lacunar old bilateral frontoparietal infarct with changes of cerebral atrophy nd doctor also made a suspicion of parkinsonism and she is stared with tab. Pacitane. What should b done hence forth to avoid more complication. And what can happen at worst [/INST] I carefully read your query and I am sorry about your grandmother's health issues.The diagnosis of bilateral infarction would justify her symptoms. A lacunar infarction is small but since you say frontoparietal meaning involving two lobes I guess there must be multiple ones. Those infarctions have already happened now can't take them back but you can reduce the risk of further ones in the future by treating hypertension and high cholesterol you mentioned as well as with aspirin. The risk of her having a stroke will remain significant but by these measures we can lower it.As for the atrophy if severe it could be a sign of dementia, meaning a fall in her higher mental functions like memory, speech, judgement, complex tasks, planning and organizing, etc, if that is a case it is a progressive disease which could progress for years and render the patient unable to take care of herself and immobilized in bed. But I'm saying that just because you asked for worse case scenario. At the moment there is no diagnosis of dementia if there are no higher mental signs you have noticed, it's not defined by atrophy, atrophy is an aging process which can be found also in old people without dementia.There are many types of dementia, most frequent is Alzheimer's disease, but if there is Parkinsonian syndrome it can manifest dementia in advanced stages, as well as imbalance. Regarding the treatment pacitane is used to treat parkinsonian tremor, but you should be careful in old people as at times it cause psychic symptoms like hallucinations, agitation. I hope to have been of help. </s>

<s>[INST] I .have had a recurrence of costocondritis for the past 6 months. I originally had it a few years ago after severe coughing and bronchitis. I have tried physical therapy with ultrasound and estim and exercises that eased the pain for awhile along with taking Aleve, Motrin, etc icing and heat help temporarity. I also tried voltaren gel. It gets a little better then I unknowingly do something to aggravate it and it s back with a vengeance. Sleeping is very painful and difficult. I have seen my internist, orthopedist and a pain management Dr who suggested injections that I am reluctant to try. I am normally a very active person going to the gym 3 to 4 times a week but now not able to go to the classes I love. In my case it is on my right side. I am really frustrated and cannot find a Dr that can solve this, I have had chest xrays and MRI on spine as well. What do you suggest? I need help and cannot find anyone who specializes in this.Thanks for reading this I would really appreciate any guidance you can give me. [/INST] HelloIn your case a chest x ray and some blood tests are needed (CRP hemogram)After the results it will be the correct treatment.RegardsDr.Jolanda </s>

<s>[INST] I went to the clinic today and the nurse checked my blood pressure. It was 137/95 and my pulse was 126. The last few times I have had my blood pressure checked it has been high. I am overweight and do suffer from frequent headaches. At what point is my blood pressure worrisome? [/INST] Hello and welcome to HCMI have read query your queryI hope this will helpHigh blood pressure is defined as blood pressure of more than 140/100 mmhg.You haven't mentioned your age but the BP reading that you have told is perfectly normal for me.you shouldn't worry much at the moment.. I will advise you to have a regular blood pressure check same time each days for 7 days.make a table and consult your GP again for further advise.take tab paracetamol or aspirin for headache.try to reduce your weight and do regular exercise. I hope everything will turn out to be normal.Regards Dr faeza </s>

<s>[INST] My husband had seed implant with radiation at Radiotherapy Clinics of Georgia 6 years ago. He goes every 6 months for his PSA check and faxes it to Georgia. They keep a data base of everyone s PSA level. My husband had his checked in August 2013 it was .0233 3 months later it was 7.8 a week later for a recheck in case of error it was 8.3 the only thing he has done different is to take allergy pills and Benadryl. For a month he has suffered sneezing and runny nose, we thought may be caused by wearing his C-Pap, maybe he has contracted Bacteria from the hose in his nose. What should we do? [/INST] HIThank for asking to HCMLooking to history given here I would suggest just do nothing for cold and running nose this will go away without any medicine, just general care would be enough, take little hot drinks drink much water, have steam inhalation, watch for body temperature if it goes on higher side then the secondary infection is likely, but this will come around, nothing to worry have nice day. </s>

<s>[INST] I HAVE BEEN DEALING WITH TS, OCD,DEPPRESSION, BORDERLINE SCHIZOPHENIA, FOR MOST OF MY LIFE. SEVERAL YEARS BACK I BECAME DIABETES, I M 59. I;VE BEEN ABLE TO WORK IN A FAMILY BUSINESS. WE YYYY@YYYY STALL LAMINATE TOPS ETC. I M WONDER ING IF WILL BE ABLE GET ON SSDI. THANK YOU. have been dealing with ts, ocd, bi-polar , deppression, bordline [/INST] HelloWelcome to HealthCare MagicI can certainly understand your concernSchizophrenia require treatment with antipsychotic medications along with SSRIs to treat OCD and depression. Treatment may extend upto 2 to 5 years. Post your further queries if anyThank you </s>

<s>[INST] Hello i am a 16 year old male and back in july i found i think around six bumps on my sublingual gland they are small an can only feel them with my tounge i cannot feel them with my finger . Also they are hardly noticable when i try to look at them. They also do not hurt. But they have been here since july only on left sublingual gland by the way. But my mom called the doctor in like september qn he said it sounded like nfection an that it could last up to six months but its been six months and thats the reason its bothering me because it is february now. But there hasnt been a big change since then also i am healthy but i was born three months early i weighed a pound an 13 ounces dont know if that will help out but im not forsure its cancer just wanna opinion thanks!! [/INST] Hi, Relax, these might either the blocked sublingual salivary glands (mucocele) or lymphoid follicles. Either of them will not cause you any harm or cancer. If it were to be an infection it would have caused lots of pain, difficulty in having food and also it can not remain for so long. Regards Dr. Naveen Kumar </s>

<s>[INST] Dear sir, last month 22nd( 22 sep 14 i had a sex with one girl that time,the condom has broken, after till month i didnt do any thing, even i didn t feel any HIV symptoms,now iam going to semen culture test,in this test shows any affection of HIV,or not? [/INST] Hello I am Dr Aamir and I will be answering your queryYou should Elisa and pcr test for HIV .dementia culture will not tell you about HIV.Also symptoms of HIV does not come so early so the only way to diagnose is to do these tests mentioned you.I hope I have answered your query.Take care </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, I am 22 years old, male. I have one weird problem when I take snap at afternoon, I am feeling sick and sweaty and when I do not, I am feeling normal, what problem is this? [/INST] Hello. In afternoon especially after lunch, one tends to feel sleepy as maximum blood is diverted to the GIT hence one may feel drowsy and lethargic and weaker. But if you tide away this episode then endorphins take over and you may feel energetic and normal. </s>

<s>[INST] hi, i am 16 years old and i was playing baseball in gym. i was on first base and a kid elbowed me accidentally really hard in chest. i went to nurse because my chest hurt but they said i would be OK because she took my blood pressure, heart rate, and oxygen level and it was all perfect readings.she did it twice and both times they came out perfect. should i worry about it? [/INST] Thanks for your question on HCM.In my opinion you should not worry much as your all body parameters are normal. But still I advice you to get done chest x ray to rule out internal organ damage.If this is normal than no need to worry. Try to follow these for symptomatic control.1. Avoid strenuous exercise.2. Avoid heavy weight lifting. 3. Avoid bad postures in sleep.4. Take good painkillers and muscle relaxant. 5. Apply warm water pad to the affected part.6. Wear chest belt for minimal mobilisation of affected part. </s>

<s>[INST] HELLO,AND THANK YOU.I HAVE HAD NECK PAIN AND SEVERE BONE AND MUSCLE PAIN FOR THE PAST 2 WEEKS NOW,I AM A CHRONIC PAIN PATIENT AND ON PAIN MEDS. ALSO.SHOULD I SEE MY G.P. FOR THIS ORMY PAIN MNGMT.DOC'S,WHICH ARE TOPS IN THE PHILA. AREA?THANK YOU BERNIE BRUCKS SPINAL STEONCIC PAT.FEEL FREE TO CALL ME ANYTIME.215-633-8231 [/INST] Hi,Get xray of cervical spine in AP and Lateral view done and send me the report.Till then have tab. aceclofenac+ thiocolchicoside twice a day, tab. pregabalin+ methylcobalamine at night, antacid in empty stomach.Apply hot packs.Definitely pain will go.If pain still persists after 7 days you can consult your doctorThanks.Dr CHANDER MOHAN SINGH. </s>

<s>[INST] hi Doctor, i have a questions to ask. i have a lump on the left side of my labia minora lower side. it hurts when i touch and wipe when i pee. it started last week with small and i thought it is pimple so i think it will go away soon. but it is bigger than last week and i am so worried. can you help what is this? [/INST] Hi, dearI have gone through your question.I can understand your concern.You may have some benign cyst. It's common to have benign cyst. You may have some soft tissue tumour. You need examination for exact site, size and nature of lesion. It will help to reach the correct diagnosis. Then you should take treatment accordingly. Hope I have answered your question. If you have any doubts then feel free to ask me. Thanks for using health care magic.Wish you a very good health. </s>

<s>[INST] Hi doctor, I clench my jaw a lot, and my mouth hurts quite a bit from doing so. I need to fix the pain from clenching. Kindly help me. [/INST] Hello. For further information consult a dentist online --> </s>

<s>[INST] Hi, I had an itch on my arm, and scratched it a little, normally a rash would develop,but this time, little red spots(lots of them) appeared, 2 days back I had the same thing occur on my thigh.I'm worried that it is petechiae, or I'm just being paranoid because it could be a sign of thrombocytopenia, and I'm kinda worried. Should I go get it checked out? [/INST] Dear patient!Welcome to HCM!Itching may be caused by many medical conditions of skin or other organs symptoms of whom are showed on the skin. Many of them may be associated with blood analysis alterations. Just make a complete blood count at first, and then go for an appointment with the dermatologist.Kind regards!Dr Eriol. </s>

<s>[INST] my skin is burning like a fire... i consult skin specialist doctor i had no result.. he given some tablets and creams.. one of cream is sunstop... my face had black pimples .. what i will do? please doctor give some special cream to my face.. to glow up and looks to my face...as white tone! and also soap which glow my face.. thanking you doctor.. [/INST] Hi..dear sohail., Thanks for choosing HCM.., Burning sensation of skin..., usually due to Using of different types of creams.., and exposure of the sun continuously.., So first avoid the sun exposure.., 1) Use SUNSCREEN LOTION...SUNBAN AND SUNCROSS., 2) Momentasone cream night times.., 3) Acnesol lotion every 2hrs., 4) Tab Isotretinoin 20 mg daily for 1 month.., thanQ </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] Hi, ok I had a tubaligation 3 years. Ago. And now for about 6 days I have been having lots of pressure in my lower stomach a little crampy on each side of my lower part of my stomach then it would do away and come back again but the pressure stays for a long time, I have been tired, and mody.. So I assumed my period would be here cause I had it last month on the 7th of january, I added up the day so I took the test yesterday and it was negative what could be going on with me? Also I have thryoid diease. N iam taking meds for that, would that be why iam having symptoms like this? [/INST] Hi.Thanks for your query and an elucidate history and possibility of tubal ligations, thyroid problem and period to be related to the pains .You have a pain in the lower abdomen on both the sides. Intermittent and like a pressure. This can be due to Colitis as both sides of the colon are usually affected. This may not be due to any problem with pregnancy as you already have tubal ligation.If the thyroid tests area normal , nothing to worry about. Go for fresh thyroid tests to see if they are normal or not, if not you need to have change in the dosage. Take a mild laxative to clear the large bowel and you probably may be alright. If required you can have additional tests of blood, urine and stool and if still not helped by the medicines get colonoscopy nad ultrasonography done. </s>

<s>[INST] hi i m male 53 yrs age. having pain in right side of pelvic area & also lower back on right side since last 15 days. i took prescribed by doc cyclopam 10 tabs, then dolonex & flagyl. pl.guide me further . the pain is still der. i just did x ray of lumbosacral spine A P Platarol. thanks. [/INST] Hi, thank your for posting!I have gone through your query and I understand you concerns.According to your symptoms, I think that you suffer from lumbosacral arthritis.The diagnosis is determined by taking a lumbosacral CT-scanner, abdominal ultrasound, complete blood count, fibrinogen test and urine test.The treatment is made with non-steroidal anti-inflammatory medications and painkillers.You should also contact your neurologist.Take care,Dr. Behar. </s>

<s>[INST] At this stage, it s a little like closing the stable door after the horse has bolted - my beloved husband died on September 3rd 2008 of liver failure. He never drank, smoked, was not diabetic and extremely fit. Two years prior to his death, a routine medical revealed raised liver enzymes (all were raised). They continued to elevate over the next six months. He was perfectly healthy externally, and asymptomatic at this time. In July 2006, an appointment with a gastro. lead us to believe that my husband was fine and that she did not need to see him again. Her assumption was that he may have passed a small stone, accounting for the elevated enzymes. He remained asymptomatic until July 26th 2008 when he became extremely unwell that night and was completely severely jaundiced the following morning. This was accompanied by extreme weight loss, fatigue, deterioration and eventually death on September 3rd 2008. I, his wife, was told that what happened to him in July 2008 was a Budd Chiari syndrome, and that the elevated liver enzymes two years previously had nothing to do with his eventual death. I cannot accept or believe this, and am still desperately seeking answers. I would greatly appreciate if you can tell me anything. My beloved Gerry was 46 years old when he died and I was 38. Thank you for your time. [/INST] Budd Chiari Syndrome has a different course in different patients. Once he patient is involved in a vicious cycle of its complications or even complications due to any sort of hepatitis of any other cause, the outcome appears less helpful. The previous history may help or may not help at all in deciding the future course of this disease complex. There are associated factors like ascitis ( liquid in abdominal cavity, effect on brain, he deranged functions of the liver, kidney and other systems coul have lead to faster deterioration and eventual death. RIP </s>

<s>[INST] I was using Nexito 10 once daily for the last six months. Feeling better, I stopped using it from Jan 15 till date. After using it I was better. But from 18th Feb. again I feel certain head related problems as was earlier. Should I start this tablet again (OD). My problems are heavyness of head, dryness of eyes and uneasiness in head. But, Doctor, all the problems are bearable. I am also having sinusitis problem for which I do not take any medicine. My question is: * Should I start Nexito - 10 (OD) again and length of period to be used may please be informed. I do not want to have medicine unnecessarily. I like to use this Nexito -10 tablet on S.O.S basis, but not continuously. * Alongwith Nexito - 10, should I take any antacid cum digestive tablet? * What is the negative side of using Nexito-1o for a considerably long time. With regards, h. roy, 59 years (Male) [/INST] Hello,Welcome to Health Care Magic.Thanks for writing.I am Dr.Saddiq ul Abidin. I have read you question completely, i understand your concern and will try to help you in best way possible.It would have been more appreciable if you would have narrated the circumstances in which you were prescribed Escitalopram (Nexito) and whether it was a decision of a psychiatrist or was it second by a psychiatrist after been prescribed by a GP? If it is so, and the assessment of condition, apart from your headaches, for which it has been prescribed, hence the decision to decrease or continue its present dose, would lye in the domains of a psychiatrist. As far as its long term use is concerned, such medicines and other to belong to SSRI are actually meant for quite long time usages. Although these have shown to have some side effects like dizziness, dependency, Long QT syndromes ( certain heart beat abnormalities), withdrawl effects and certain drug interactions, still their use shouldn't be discontinued at your own discretion.Also regarding your query, to use stomach protection, isn't necessary along it, rather it has shown to have certain interactions and increased tendency of some skin infections in the outcomes of certain trials done for their concomitant use with Omeperazole (PPI), a stomach medicine.Your sinusitis can entirely be a different entity or can also be, on other hand, contributing to the headaches, for which you should have a detailed ENT examination and X-ray Para nasal sinuses, to diagnose it, and if proven, then it may necessitate the use of certain antibiotics, along with antihistamines and anti-inflammatory medicines for its proper management.Regards,Dr.Saddiq ul AbidinM.B.B.S(Licensed Family Physician)Resident Medicine. </s>

<s>[INST] helli I have a lump inbertween my cheekbone and jaw bone the gap between them I noticed it this mornin and my cheek felt tender I played around abit and found a painful lump its squggy too ive read online and aounda like a saliva gland but i panik about everuthing its very tender I alsi gelt the other side and have it there too but not sore at all ? Help please [/INST] Hello and welcome to HCM,The lump between the cheek and jaw bone requires an imaging study- a X-ray.X-ray of the region will show whether the swelling is arsing from bone or not.In case the swelling is arising from soft tissue, an aspiration cytology of the lesion is required.The cells are aspirated from the swelling, cells are spread on slide, cells are stained with appropriate stains and studied microscopically.The aspiration cytology will determine the origin and nature of the lesion and thus further management can be planned.In case the lesion arises from soft tissue excision of the lesion can be done.Thanks and take careDr Shailja Puri </s>

<s>[INST] Hello, I am writing you all because I am in desperate need to help my girlfriend. She has been having seizures everyday anywhere between 1-6 times a day no for the past 7 months.She's seen two neurologists and all tests on the brain come back negative. She was tested for epilepsy and those tests came back negative. However very bright or flashing lights can instantly send her into a seizure, as well as loud noises.Her menstrual cycle is very horrible as well. She frequently has blood clots which causes her flow to be abnormally heavy and the pain unbearable. Sometimes when she has her seizure afterwards she can feel a very sharp pain in her head and through her body, her vision seems to get blurry in her left eye, he left side has also gone limp and shown symptoms of a stroke, but that was ruled out as well.She is anemic and has low iron levels. We are not sure what is causing this and I need immediate help because It is gradually becoming worse and I am in fear she may lose her life if help is not given. No doctors will even prescribe her any meds for her seizures so we resort to high grade marijuana which has seemed to help, but not treat the symptoms.I did some research and thought she may have lupus or some type of anemia caused by low hemoglobin levels. She just turned 25 and is a black female if that may make a diagnosis easier. [/INST] Hi,Thank you for posting your query.First of all, we need to make a clear cut diagnosis in order to decide the treatment. At this point, there are two main possibilities- first, epilepsy and the second, non-epileptic (psychogenic) seizures.The diagnosis can be established by doing a long term (24-48 hours) video EEG recording. As she has several seizures per day, it is possible to record her seizures on video and see the EEG pattern during those seizures.After diagnosis, she would either need anti-epileptic seizures or psychological treatment.I hope it helps. Please get back if you require any additional information.Wishing you good health,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad, IndiaClick on this link to ask me a DIRECT QUERY: BLOG: </s>

<s>[INST] Two days ago, I stood up and felt a severe pain in my upper back, about an inch to the left of my spine. I am dizzy and feel weak. The pain is worsened when I bend over or walk. I am a fairly healthy 38 year old woman, although I do have a history of stroke and I smoke. [/INST] Hi, Welcome to HEALTHCARE MAGIC. MANAGEMENT OF acute back pain is rest in the position of ease ,analgesics(diclofenac),vitamin supplementation. LOOKING to your query it seems to be due to prolapsed disc It is confirmed by clinical examination and MRI scan.I think my answer will be helpful to you. </s>

<s>[INST] I recently used Henna hair dye , I applied and left it over night...I woke up the next morning with a burning sens ation on, the sculp and expierenced hair lose. I feel very weak and my knees shake...I also feel very dizzy, can it be because of the Henna? An alergic reaction? Please help. [/INST] HI, thanks for using healthcare magicIt is likely a reaction to the chemicals in the dye likely due to the prolonged exposure. In most cases , it is applied and left on the scalp for 1 to 6 hours.The extended exposure would have caused these symptoms.It may be best to consult your doctor for a review. Medication may be needed if there is damage to the scalp or any other areas.I hope this helps </s>

<s>[INST] I am away on business and have had a sever cough for about 4 weeks. I have double ear infection and sinus infection as well. I wound up in Emergency clinic last night due to severe pain in lower right ribcage. The coughing is merciless. They gave me a shot of steriod, Albuterol breathing treatment, took me off of Amoxicillin and gave me Levofloxacin, Benzonatate for coughing during day and virtussin for night cough as well as inhaler (Albuterol) The xray indicated I had Pleurisy. I need to get home. Can I fly with Pleurisy? I don t want the pressure to create further complications. My husband had it and the sak burst. I am concerned about that happening due to flight pressure. My pulmonary doctor hasn t called me back, but I am trying to make travel arrangements home. Thank you, Jen Moran [/INST] Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. Travelling by air should not worsen your pleurisy. All the medication given will take care of infection which should settle in a weeks time. Hope I have answered your query. Let me know if I can assist you further. </s>

<s>[INST] Hello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance. [/INST] Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online --> </s>

<s>[INST] for 5 month old girl baby, doctors saying that cortico meddullary differentiation is lost and there is a increase in renal parenchymal echogenicity.can you please tell me is it danger for baby and please suggest me what is the treatement for this. Hi, may I answer your health queries right now ? Please type your query here... [/INST] Hi, It means that there is chronic kidney disease going on and that she will require regular follow up with a pediatric nephrologist. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Sumanth Amperayani, Pediatrician, Pulmonology </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] Hi What are your qualifications? and whom am I speaking with I had a CT scan recently that reports thickeneing on the bibasal lung fields. I am 44 years old never smoked. I have a history of asthma and have had multiple pneumonia and bronchitis infections. I often feel lethargic dizzy and nauseous could it be related to my scan results.Recently my LFTs are also abnormal ALP elevated. My GP must think Im a hypochondriac as I often consult him for testys when feeling unwell and I have no answers as yet [/INST] Thickening in the bibasal region may be because of pleural thickening or may be because of resolved pneumonia with fibrosis. It may be because of asbestos or chronic bronchiectasis a common sequel of infection . But in all these I don't think if you are symptomatically better there is any need of any intervention . Just think it's old scar of your previous infections . Your feelings of dizziness lethargic and nausea do not seems to be because of it.but as you have mentioned your liver enzymes are elevated this may be the cause of nausea and lethargy . You discuss all this with your physician he can better assess you and can explain you better.if he think that you need opinion of pulmonary specialist then he can refer you to him but first of all its internal medicine doctor who can assess you best in my opinion . Hope this will help..I am MD internal medicine . </s>

<s>[INST] I am 72 and in good health but about two weeks ago I began to get these sensations in back of the head. they don t hurt just a bother and I wonder is this PARESTHESIA and should I worry other wise I feel fine. Everyday I feel as though it will go away but I will have my check up on Monday Nov. 20th and I will mention this to my Dr. thanks [/INST] Hello and thanks for your question here at HCM. I have read your question and understand your concerns. Paresthesia points to symptoms, the probable condition that may cause such issues is occipital neuralgia that is linked to the upper cervical nerves who may be pinched or compressed. Yes, you should mention these issues to your Doctor since you are going for check up. Your Doctor may undertake other steps to diagnose you correctly. Hope I have answered your query. Let me know if I can assist you further. </s>

<s>[INST] Dear Doctor, I am 73yrs old,I do take blood pressure tablets,I have experience highs of 245 over 110, lows of 90 over45.I have had blood tests done all seem to be o.k. But lately Iseem to be having no energy, the heart seems to be hiting very hard,I sweat alot around the neck, and forehead, even when I am in bed, also I feel very hot inside my body which makes me feel very listless and tired. My weight is 80kl height 5ft 9inch [/INST] Hello thanks for posting here. i have gone through your description. Since you suffer from high blood pressure, some of the above symptoms like pounding heart, hot inside body can be due to high BP during those episodes. Feeling of tiredness, fatigue, listlessness can be caused by a number of factors. Going by your history and my experience, i consider the following probabilities here. First is vitamin D deficiency which can cause tiredness, fatigue. Get your vitamin D levels checked and if it's low, correct it by taking vitamin D supplements usually the once a week tablets. This will drastically reduce your symptoms in 2-3 weeks. next possibility is heart disease which can also lead similar symptoms. Don't worry, it's better to be safe than sorry. Since you have a high blood pressure history, and your age is 73, i advice you to undergo a cardiac check up which should include a ECG, 2D echo and a treadmill test. These tests are very sensitive to evaluate cardiac disease. So to summarise i would advice you to do a vit D levels, fasting and post lunch blood sugars, ECG, 2 D ECHO and treadmill test. wishing you good healthregards </s>

<s>[INST] Hi, i was lifting stuff yesterday... and when i went to bed last night my back was hurting, when i woke up this morning it was worse i was all most crying in pain, i have tired pain relief, rest and hot packs but nothing seems to make it better or worse what can i do ? [/INST] Hello! Welcome to HealthcareMagic! Take tab Simhanada gugglu 2 tablets, 3 times day along with Mahanaryana taila or oil apply. It will cure your problem. Thank you for contacting us. Hope this clarifies your concerns. Take care Regards, Dr. Naser Jani, Ayurveda Specialist </s>

<s>[INST] my 18 year old son has been waking up with really bad pain in his right adomal area for a couple of weeks. i took him to accute care, they checked his apendex and did some blood work. he had some unexplained fluid in his abdomal area.they said it should absorb into his blood stream. he is still sick and has lots of pain. it seems worse in the mornings. can u help? [/INST] Please do mention other reports as well to receive better suggestion from HCM. There has to be reason behind bad pain.Collection of fluid and pain together suggest of some pathology in abdomen which the sensory system is experiencing.Was his ultra sound whole abdomen done? If yes please fill in with detail findings. If not then get it done.He may be suffering from a most common worm infestation or acid peptic syndrome or any liver pathology or may be even abdominal Kochs. Please get detail investigation done and see your doctor. </s>

<s>[INST] my father was bitten by a copperhead snake thursday. he spent from late thursday night until about 3 pm sunday in the hospital being monitored. No antivenin was administered due to the fact he only has one kidney and a previous heart attack . was bitten on the hand...swelling was on hand, arm up to and past the elbow... but down dramatically when released on sunday.Swelling still down now as well. Is now experiencing bad pain since about 5 am this morning, chilling, and lungs feel odd. Is this normal? [/INST] Thanks for asking in healthcaremagic forum In case of snake bite, if poisonous anti-venom is administered irrespective of your condition to save the life. In fact snake venom can cause kidney damage. So, you are not aware of the treatment details. Please consult your treating doctor regarding this. All the best. </s>

<s>[INST] Hi Doctor, I am Kapur/28/M. from last month I am having cough/ cold related symptoms. I was taking antibiotics and other tablets. In LFT my sgot is 55 and sgpt is 74 bilrubin 0.9 direct bilrubin 0.2 and indirect bilrubin 0.7. Also my weight got reduced by 4 kg. I saw many doctors and most of them are concerned only about bilrubin and told me that other counts are fine and asked me to medcine for cough/cold and liveril forte for sgpt control. Can you please guide me. [/INST] Hi, Thanks for writing in. Certain antibiotics can cause alteration in liver enzymes. In your case the alteration is very minimal and should not be a cause for concern as other liver enzymes are normal. You can continue with liver tonics containing ornnithine such as hepamerz tablets. Stop the antibiotics as early as possible. I hope this answers your querry. With regards </s>

<s>[INST] My daughter (20 yrs old) in otherwise excellent health, has a blistery bruise on the back of her left hand near the outermost knuckles. There are small blisters associated with it. It has been there unchanged for two weeks. No known trauma associated with it. Any ideas? [/INST] Dear Sir/Mam,I understand your concerns about the bruises your daughter has.Always a complete workup must be done to exclude serious diagnosis related to platelets and blood clotting factors that might cause thisissue.That is why she should do these tests : CBCD, PT,INR,PTT, bleeding time, peripheral smear. If all these tests are normal then there is nothing to worry about.I would recommend the following tips also :Immediatly after the appearance of the blood patch on your skin put cold compresses for about 20 minutes per hour for few hours, then the next day put warm compresses to help the resorption of the ecchymosis faster. Also the use of creams containing aloa vera might help the skin to become healthier and resistant to trauma.Best regards </s>

<s>[INST] I am a 42 year old male. Last year at my physical I had borderline elevated liver enzymes . Over the last 4 days I have had right sided abdominal pain that was brief and went away. It continued so I went to see the dr. He did full assessment and nothing was enlarged or seemed abnormal during physical exam. He did my blood work. Tonight he called and said my liver enzymes were off the chart.( no number given). I have no other symptoms. [/INST] Hi and welcome to HCM It sounds to me like billiary colic. Ultrasound should be done to detect is there any stone in gallbladder. If you have pain after meal, especially fats and alcohol then it would confirm my opinion.Also elevated enzymes are found in gallbladder disorders. Physical examination can find enlarged liver or spleen but gallbladder cant be examinated without imaging tests. Till you do this you can try with dieatary changes. Avoid fats smoking,alcohol and see is there improvment. Wish you good health. </s>

<s>[INST] Hi I want to know that before 2 months I have conceived but it had be miscarriage. Now I m planning again to conceive. my doctor has suggested to take progynova 2 mg twice daily for 5 days and also ovanac cc for 50 mg once daily. and also an tablet cabgoline. what do you think is it all are correct and please tell me why these are used? [/INST] Hi thanks for asking on HCM.Progynova is estrogen tablets and ovanac is used in combination with these for ovulation induction.Cabegolin is used to reduce the incidence of ovarian hyperstimulation syndrome which can occur due to ovulation induction drugs.These drugs are useful if you have defective ovulation and other factors for infertility including male factor should be ruled out before starting these drugs.Good LuckHope this information is helpful and informative.If you have further queries you can directly reach out to me on the following URL: </s>

<s>[INST] my 3 year old got a hickie on his arm from his 9 yrs old brother My 3 year old son got a hickie on his arm from his 9 year old brother Step brother (his the son of my husb and has been living with me for the past 5 years) The problem is that the brother lies over and over shoud I worry about this? How should it be handle? is is normal for a 9 year old to experiment with hickies.....AM i overreacting. Am just upset because the 9year old lies all the times am afraid of what else he might lie about... [/INST] Hello and welcome to health care magic,please take consutation with a dermatologist,as if the disease is then it is to be worried but if it is not then nothing is to be worried ,have a fungal scraping, tu rule out fungal etiology,take </s>

<s>[INST] i get slight pain in abdomen upon orgasm but no sperm comes out. what is wrong? i am 64 years old male. 5'11 220 lbs.i do take symbicort[3 puffs twice a day, 175 mg. synthroid, 10 mg lipitor, flomax, 81mg. aspirin and multivitamin as well as vitamin c and d and omega 3. thank you. [/INST] HiGreetings Have you undergone any prostate surgery?Or taking any medicine for urinary complaints?If not you will need a direct check up with urologist. HOPE MY ANSWER HELPS YOU Regards </s>

<s>[INST] My 16 yr old son has been feelin chest pains & tightness in his chest n throat for about a week now....hes also been very tired and headaches. I took him to the family dr and and he thought he had asthma, precribed proair inhaler and it made him feel worse than before. Stopped taking inhaler had a pulomonary test done, his lungs look healthy... Dont know what to do...? [/INST] Respected user , HiThanks for using Healthcaremagic.comI have evaluated your query thoroughly .* This indicates systemic manifestations of underlying pathology which may be low hemoglobin or pyrexia of unknown origin .* He requires work up with laboratory evaluation to find out the cause & manage accordingly .Hope this clears your query .Welcome for further assistance .Regards . </s>

<s>[INST] Hi, may I answer your health queries right now ? Please type your query here... My 14 month old son foreskin can finally be pulled down now... As I was cleaning it, I saw that the top of his penis was red and had a small red circular spot. Can u help me?? [/INST] Hi...Thank you for consulting in Health Care magic. 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. Please revert back to me with images so that I can guide you better.You can approach me at the following link.Once the page opens there will be an option below my image as – ASK ME A QUESTION – click on it.Please find the link below -www.healthcaremagic.com/doctors/dr-sumanth-amperayani/67696Regards - Dr. Sumanth </s>

<s>[INST] hello i m lubna .on my left hand wrist bone there is a gland appear diaqurine.i did physio therapy 15 days but it dint reduce.i cant hold heavy thing in my hand i m lefty.it tightens my hand from thumb to wrist gland daily .i have to do exersice then my hand is able to move properly.kindly tell me what i should for this gland? [/INST] Hello, The sudden appearance of a gland can be due to a ganglion. This can cause compression on ligaments.Do consult your orthopedician for proper treatment. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Praveen Tayal, Orthopaedic Surgeon </s>

<s>[INST] I have been suffering from severe joint pains now for a month and a half.it all seemed to start after a virus I had for weeks.No matter the medication I take it just masks the problem and it returns. In the morning when I get up I have problems getting out of bed and walking. Some times even the bottom of my feet ache.Can you give me any ideas what I may be dealing with? This is starting to affect my daily life big time! [/INST] Hello, Consult an orthopaedician and get evaluated. You can take analgesics like Ibuprofen or Diclofenac for pain relief. If symptoms persist you can consult an orthopaedician and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Shinas Hussain, General & Family Physician </s>

<s>[INST] Hi Sir, Me and my girlfriend had unprotected sex last month and her cycle for this month was about to start on 4th Feb but has not occured till now. We are very concerned if she is pregnant. Please advise on what to do now and how to avoid her from being pregnant ? [/INST] Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. You have unprotected intercourse history. So yes pregnancy chance present. If conception occurs than after implantation placenta start developing and produce HCG hormone. So if your period delayed for week than investigate with urine HCG card test. If you want to rule out early before one week of delayed period than blood HCG estimation advisable. Hope I have answered your query. Let me know if I can assist you further. </s>

<s>[INST] i came in from my work which was night shift, i had some toast and tea and went to go to bed and i had a tight chest and felt i needed my inhaler, i got back upstairs and collapsed on the bathroom floor and blacked out for over 2 mins and then came round and felt sweaty and cold. [/INST] Fainting or syncope can be due to number of reasons. It can be due to low glucose, sudden drop in blood pressure or due to abnormal heart rhythm. If you are feeling chest tightness or palpitation(racing of your heart) then see a cardiologist. </s>

<s>[INST] My legs have been tingling everyday now for 2 weeks. 3 years ago my md said I have a very high Ana and referred me to a rheumatologist and they said I don't belong there because at that time I had no symptoms. Could this be an onset of lupus at age 49? Female [/INST] Dear Madam,Yes there is a possibilty but a NCV of your limbs is necessary to look for what kind of neuropathy is there.Dr. Shruti </s>

<s>[INST] Hi Doctor, I have cervical spondilosys and low back pain. My work involves sitting for long hours at a stretch. I get relief when i exercise and get fomentation or massage. Is that ok if i continue with this? I also want to play badminton which i find to be of help. My question is can i continue with fomentation, massage an playing badminton? [/INST] Cervical spondylosis is an age related degenerative disease. You can continue hot fomentation and massage but excessive neck turning or movement should be avoided. Isometric exercises for neck and back strengthening exercises may help more. Long period of sitting in wrong postures may aggravate neck and back pain so avoid as much as possible. Playing badminton depends upon status of your lumbar spine and will be better advised after your lumbar spine imaging. Intact vertebral column with no collapse or spondylolisthesis will assure for continuing badminton. </s>

<s>[INST] Dear doc: I have a history of asthma and panic attacks but have recovered from asthma since i entered adulthood.Due to extreme stress lately, my panic attacks are always followed by an asthma attack as well.Sometimes, the reverse happens. This condition interfers with my life greatly and i have been more depressed as well. [/INST] Hi,I can understand your distress associated with panic attack and asthma. Panic attacks can often present as severe breathlessness and can mimic asthmatic attack. You should be initiating treatment for both conditions. For treatment of asthma, you should seek a pulmonology consultation. Depending on the frequency of attacks, you can be either put on prophylactic medication or can be prescribed inhalers.In addition, you should seek a psychiatric consultation for panic attacks and depression. Treatment with medication like sertraline or paroxetine would be beneficial. You can also learn some relaxation exercises like deep breathing and progressive muscular relaxation which will help you relax.I do hope that this information was helpful. Best wishes. </s>

<s>[INST] Just saw a patient (11yo) prescribed cephalexin for 10 days for cellulitis of toe 5/31/14. Sensitivities included cefazolin but not cephalexin. Can these drugs be used interchangeably? Child presents today with scattered maculopapular rash and red skin with hot flashes , malaise since yesterday. Am wondering if this is a drug vs staph infection rash. She looks ill. Did not do vitals or examine as knew needed more evaluation than available in retail clinic. [/INST] Hi..your paediatrician was right in starting Cephalexin for cellulitis as it is a good antibiotic of skin and soft tissue infection like cellulitis and has narrower coverage too. But as you say the kid is still ill - I would look for 2 possibilities - 1. Is the duration of Cephalexin already more than 3 days - without good response?2. Are we dealing with a more virulent organism - if so I would prefer Clindamycin.Regards - Dr. Sumanth </s>

<s>[INST] Hi, may I answer your health queries right now ? hi sir, my friend took harpic before six months. soon after she took we made her drink more water,, now she developed allergy in her leg. is tat due to harpic? wat r the side effects we expect in harpic poisoning...? [/INST] Hi,Harpic contains hydrochloric acid with butyl oleylamine in its aqueous solution.It may cause allergic reactions but if your friend has taken it before 6 months then I don't think so,this allergy over legs could be dye to harpic exposure done before 6 months.This allergy might be something else but can't be due to harpic.Thanks and regards </s>

<s>[INST] Hello doctor,I am trying to conceive but my husband and I did cocaine a week ago. How long should my husband and I wait to safely continue to try to get pregnant? How long until it is out of our system? How long does cocaine stay in sperm? Thanks in advance. [/INST] Hello, Wellcome to iclinq.com. There are few researches/studies on cocaine use by males and its effect on pregnancy. Few suggest that cocaine by itself has limited effects as most of the time it is taken along with other drugs or as a cocktail of alcohol and cigarette (tobacco). So, most of the people take not just cocaine but a combination of drugs. Cocaine narrows blood vessels (vasoconstriction). It can lead to erectile dysfunction. Few studies suggest that it has receptors on testicles and sperm. So, it can degenerate testicular tissues/or sperm quality, transfer from sperm to female egg and can lead to early miscarriage. Cocaine is a very fast acting drug which affects the nervous system and produces short-lived euphoric attitude for 15 minutes to an hour, but causes long-term damage to the body and brain like anxiety, depression, aggression, impairment of logic and critical thinking, heart problem, hypertension and decrease in bone density. Its half-life is an hour. So, it takes about an hour for half of the cocaine consumed to leave the body. But, with long-term use, the drug starts to accumulate in the blood and body tissues allowing certain tests to detect it in the system for an extended period of time. After a single use of cocaine, agents created by its metabolism can be detected in the urine for two to four days, and in chronic users, cocaine can be detected up to 12 days and highly concentrated cocaine can be detected in the urine up to three weeks. It can be detected in the saliva and blood for an average 12-48 hours. In hairs and sweat for an extended period of time, it can be detected. So, after all the above description, I do not know how your husband had cocaine, as a cocktail along with other drugs, or just cocaine? Secondly, how long he has been taking it? For you, have you been on alcohol, cocaine or smoking? If you had taken in the past, better to quit completely. My advice is, try to avoid drugs like cocaine, alcohol, ketamine, and MDMA completely for a couple of months before trying for pregnancy. Because, if the mother has an addiction, it has psychosocial effects on the fetus in addition to the drugs' side effects itself. Best of luck. For more information consult an obstetrician and gynaecologist online --> </s>

<s>[INST] Hi I am 31 year old and want to plan a family. My gyne prescribed me 3 medicines Sepluva 100 mg for 5 days (3 - 7th day) (I am not sure if i have spelled the medicine correctly) Progynova 2mg - 16 days (8th - 16th day) Lupigest 200 mg 10 days (17th - 25th day) i have a regular 30 day cycle, sometimes I have my periods + - 2 days but most of the time its 30 day cycle. I have 7 day flow which sometimes is normal flow and some times its heavy. I have had appendicectomy 2 years back. My husband sperm count is 21million per ml. Do I have a chance to get pregnant and these medicines are of any help. [/INST] Hi, Perhaps your gynecologist put you on ovulation induction with Clomiphene, along with estrogen and progesterone to maintain the cycle. you seem to be responding well to treatment. You should also get your tubal patency assessed in view of the history of surgery. Your husband's sperm count is normal, if the motility is around 60%, there should be no reason for worry. You may take some time before you can see some result, and patience is always needed when going to treat infertility, both for the doctor and the patient. Good luck. </s>

<s>[INST] hello I am 35 weeks pregnant and did a liver panel and my AST level came back and is 62. Everything else is normal. I ll be seeing a doctor next week, but I m wondering if I should be concerned or if there s anything to know before I speak to the Dr. [/INST] hello. there is no concern. the elevation of the livery enzymes can be normal but you need close follow up and regular blood tests </s>

<s>[INST] Hi my question is that my girlfriend isn t feeling very well, we just went bowling and she felt like she was about to faint,dizziness, and also she feels like she s hot in the inside but cold on the outside. This also isn t the first time this happened two weeks ago she fainted from the same symptoms. I was wondering what it could be. [/INST] Welcome to HCM.She has very vague symptoms.Go for routine blood test And start treatment accordingly.Start haemetinics,complete course of intra muscular inj.B 12 will be helpful.Eat good nutritious diet,drink enough water and other liq. like lemon and other fruit juices.Avoid stress.Do regular exercise.Consult your physician for better medical management. </s>

<s>[INST] My problem is tha t I always seem to develope a rash between my legs after an intense workout or after spending a few hours doing yard work. I know I have sensitive skin, and the powders and sprays that I use don t seem to help......any advice would be welcomed. [/INST] Hi,It may be candidal intertrigo. Consult the dermatologist for the perfect diagnosis and proper treatment. It may be precipitated by perspiration. That may be followed by exercise or physical work. I would recommend you to take antihistaminics like cetirizine 10 mg and itroconazole 100 mg daily for few weeks. Apply sertaconazole cream on the affected areas. Take Sitz bath in dettol mixed water.Hope this helps.Dr.Ilyas Patel,Dermatologist </s>

<s>[INST] sir its urgent my father is suffering from throat cancer advanced stage 84 years old pls help me soon sir [/INST] Hi...Mr.Umangkapoor...I gone through your problem, age is criteria here, and cancer is advanced satage ..here we can do only palliative treatmeni i.e. 1) Intra tubal alimentation...through tube only we can give lequid food..take instructions from good Oncologist..to reduce tumor obstruction , while passsing the alimentary tube 2) Parenteral fluid replacement i.e. Saline therapy to maintain fluid balance in the body 3) According to TNM.. classification asses the present position..(T-Extent of primary tumor..,N-Lymphnodal involvement.,M- Metastasis..spreading to other organs ) Surgery and Radiotherapy is not advisable...but some regions .,there are doing Radiotherapy with chemotherapy..,hence don't do your own take advice from Oncologist o.k..,goodluck </s>

<s>[INST] Good morning doc. I have suffered chronic oral thrush for the past two years, it has badly affected my kidney, i have done HIV test more than 10 times in the space of this 2 years all negative result. I have taken various antifungal medicines still no changes, please ill be glad if any useful information that could be of help is given to me [/INST] Hello, Thnx to contact us. I understand your concern. If I am your doctor I advice you to confirm the diagnosis first. If you can do Grams staining from the nearby laboratory it will confirma the diagnosis and you can also do antifungal sensitivity testing. since some candida species are resistant to the drugs routinely prescribed.I will be happy to answer more of your concerns, kindly know me,Wish you a very good health at health care magic. Dr. Arun Tank. Infectious Disease. </s>

<s>[INST] The line that runs from my scrotum up to my penis, I don t know what its called but its like a ridge, i hope you know what i mean. when it gets to my penis about halfway up, it twists to the side, and then comes back where it meets the opening in my penis. I m uncircumsized, is that normal? [/INST] HIWell come to HCMI appreciate your concern, this is dividing line that exactly taking place at the time of organogenesis and this is absolutely normal one and this is part of human body in male person, in some subject this could be more prominent, but this is normal one and no need to worry about this, hope this information helps. </s>

<s>[INST] I have a 44 yr old nephew with autism. He takes anti seizure medications and has for years. He does not talk, is quiet and has never caused any trouble. In the last week, he walked away from home, has been talkative and destructive. Why the sudden change. He went today for a brain scan and nothing was found. He also had a nuclear med. test but not results yet. [/INST] Hello,The patient most likely developed mood disorder during which it is common for them to move out, become aggressive, violent, demanding, difficult to control and it seems that the person has changed completely by someone else.It is not uncommon presentation in patients with autism. However, there is no need to panic. You may take him to his psyhiatrist and start the required antipsychotics. Drugs like quetiapine or haloperidol or olanzapine can be give and there will be a definite improvement in his irrational behaviour. Till then please take care that he dosent harm himself or others near him. Donot become voilent or loose your temper on him as he is doing all this due to another psychiatric problem.Hope the reply is useful.Dr. Manisha GopalMD Neuropsychiatry </s>

<s>[INST] I've been having trouble with bloody diarrhea for about a week now, and stomach cramping, nausea, and exhaustion for about 3 weeks. I've also been having 2-3 periods/month. I went to the ER on Saturday after a bad bought of bloody diarrhea because it worried me, was given Cipro and Levsin, no blood in stools until today, after a run. What questions should I ask my doctor when I go in this afternoon? [/INST] you need to do stool analysis to see the exact pathogen which is causing this. most commonly this is shigella or e. coli and you need t0o do antibiogram to see approprate natibiotic for it. Regards </s>

<s>[INST] I am a senior age lady with a good blood work report going into back surgery. However my Lymphocytes is higher than the normal range 15 instead of 4-13. Also the Monocytes is 17 instead of normal range of 4-13. Is this in any way a danger? Does it have anything to do with allergies or stomach problems? I would appreciate an answer, what is our charge??? [/INST] Hi, dear. I have gone through your question. I can understand your concern. Your lymphocytes and monocyte count has no relation with allergy or stomach problems Even simple viral infection can leads to this. So no need to worry. just be relaxed. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health. </s>

<s>[INST] Hello doctor uncle i am a 19 yrs young boy i have a problem of neck is that when i used to talk with my friend then i unfurtnely i cannot explain what i want to talk over my voice every friend used to laugh and i become say and become sadness i cannot speak what i want to talk with my friend , i talk like a small baby of 3 or 4 yrs like babies talk. [/INST] HIThanks for using healthcare magicI think, you should take help of a ENT specialist or speech therapist. It would help you to improve your voice. In case, you need further help, you can ask.Thanks </s>

<s>[INST] Hi doctor, I have severe pain in the lower back region. I have this problem for a few days. The pain is present only on the lower back just above the hips. I feel stiffness and pain in the lower back in the mornings. I have the pain radiating towards my upper spine when I squeeze the upper back muscles. After a few hours, my pain goes away and comes back again after a night sleep. I always do weightlifting at home. Please suggest a remedy. [/INST] Hi. You have a muscle spasm. Evaluate your sleeping conditions and ensure that you are sleeping on a supportive mattress that is not over seven years old. When sleeping on your back, place small support under the lower back and knees. You can use a small pillow or rolled towel. When resting on the side, keep a medium size pillow between your knees to keep your pelvis straight. Try sleeping on a heating pad. Do light lower back stretches every morning and every night in every direction. </s>