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<s>[INST] Hello doctor, I cannot concentrate because when I study I feel I am not able to memorize. I want any medication maybe for 1 month for concentration. My doctor gave me Bupropion but it is no good for me. [/INST] Hello. From your query, I can understand that you are having difficulties related to poor concentration. There can be different reasons for struggling with poor concentration. More information will be needed to clarify the etiology behind poor concentration so that you can be guided about getting appropriate medication and treatment. How long have you been experiencing concentration difficulties? Was it present when you were a child and did you have problems with studying whilst at school? Or did the concentration problem start in recent months or years? Are you experiencing any other difficulties? Are you sleeping well? Are you eating normally? Are you using any alcohol or recreational drugs? If poor concentration has been a problem since early childhood, you need to be assessed for neurodevelopmental conditions like ADD/ADHD. Following a comprehensive assessment, if you fulfil criteria for ADD/ADHD, stimulant medication can be considered to improve concentration and inattention difficulties. Stressful situations and conditions like depression, anxiety can also cause poor concentration. I see that your doctor has prescribed Bupropion which is a helpful antidepressant medication. Have you been having problems with low mood ? How long have you been taking Bupropion? If it is not effective despite taking for more than 6 weeks, discuss with your doctor about optimising the dose or alternative antidepressant needs to be considered. Also, physical health problems like low iron levels, low thyroid, etc can also cause concentration problems. So this needs to be ruled out as well. So, if you are able to provide further additional information regarding your symptoms we can guide you appropriately. </s>

<s>[INST] Hi i live in west Africa i noticed that i have a ringworm like patches from the skin of my head to my feet.Doctor said its FILARIASIS adult worm i treated and the patches is yet to clear.but my fear is that has this filariasis not affected my sperm production as i am yet to pregnant my wife. my email is YYYY@YYYY [/INST] Hi yes ring worm like patches over the skin like filariasis will defnitely effects the sperm production.it can be cured by eofil thrice daily to cure the filariasis which inturn increases sperm production.filariasis usually causes spermatocele which effects the sperm production. </s>

<s>[INST] Age: 22 years Weight: 84 kg Height: 5.4 inch Sir... I am doing masturbation from last 7 years now my pinus length and width have decreased. My pinus length is 4 inch.. There is no hardness in my pinus and is very soft.. My sperm timing is zero... Sir... Please prescribed some medicines for pinus hardness and length + foods for sexual health and sperm Health... Thanks. [/INST] Hi, I think you should go for evaluation first. Do a thyroid profile, prolactin levels, serum testosterone, Blood sugars and lipid profile. A penile doppler test may be needed. Medicines are available for treatment. </s>

<s>[INST] I went to the ER for pain in the left side of my abdomen . They ran all kinds of test, the pain is between my rib cage and hip and is kind of tender to the touch. I don t feel the pain until I take a deep breath. The ER said my blood work and CT scan came out clean. i had a little bit of blood in my urine , not enough for it to be a UTI and I had just finished my menstrual cycle 3 days prior so that explained the blood in the urine. It went away and now it s back. it s been 4 days. I don t know what to do? Could it be a back muscle thing? my back doesn t hurt. [/INST] Hi, It may be due to the spasm in the back muscles that is causing the pain or may be due to concretions in the kidney that is causing the blood If it is tender it may be due to muscle have combination of 1. Pain killers such as Nuberol Forte twice a day for 05 days 2. Muscle relaxants such as Cap. Muscuril 04 mg twice a day for 05 days. There is nothing to worry about you will be fine in a day or two I hope I am sucessful in solving your query If you have more you can ask me. Take care Regards, Dr. Azhar Sattar </s>

<s>[INST] Rash. The affected area is palm size, and some smaller, circular like ringworm. The areas affected do not itch. The rash is spreading to arms. Body hair in the affected areas falls out. The rash has not spread to anyone else in the house. The rash started in 2002. [/INST] Hello,The symptoms seem to be related to a ringworm infection. I suggest using an anti-fungal cream for local application such as Clotrimazole cream. I also suggest using Fluconazole 150 mg for three days. If the symptoms continue, you should consult a dermatologist for further evaluation.Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Dorina Gurabardhi, General & Family Physician </s>

<s>[INST] under side of forearm in 6yr old had a fall today. Put hand out to stop fall some soreness in wrist and thumb area. large bruise on arm with white hard lump under. Wrist and arm swollen and tender when pressed but child can put pressure and still write [/INST] Good afternoon..!!A painful swollen wrist might be due to fracture of the wrist or forearm bones.So it's better to visit pediatric orthopedician for further evaluation and management.Thank you, have a nice day..!!! </s>

<s>[INST] hie i am AAAAAAA .how are you?? Most of the times i suffer sewer pain in the center of my stomach and it has been quite long now. Because of that i get embarissing burps. [/INST] hello. Welcome to HCM. Severe pain associated with dyspepsia (burps) can be an indication of Helicobacter pylori infection which is very common in India. It is possible that some small ulcer is also present. Sometimes, the muscles of stomach or near gastric inlet may go into spasm. It will be helpful if you avoid oily and spicy food, take off and on gastric coating syrups which prevent gastric irritation. however, even after this if your episodes subside and become more frequent, you have to visit gastroenterologist for detailed check up. take care. </s>

<s>[INST] My 5 yr old had an ear infection about 15 days ago. He was given keflex at first. The beginning of this week we took him back to the dr s and his ear infection was worse and now put on amox 400mg susp. He has been stating that his stomach is upset, head hurts in the forehead area, and has dark circles under his eyes. Is this normal with sinus issues? My pediatricion stated there is nothing to worry about and to cont to take the medication. We are just concerned. [/INST] Hello,Amox is strong enough antibiotics for ear infection. Stomach upset like loose motion is a usual side effect of it. It may be due to the same he is not getting enough rest and having dark circles or head hurting. You can use some probiotics like Darolac or Sporolac for stomach upset or use more curd in food. Finish the course of antibiotics as prescribed.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Kalindi R Shah </s>

<s>[INST] I am a woman of 49 years of age and went thru an acupuncture session with disastrous consequences. It triggered a severe autoimmune reaction in the body where the anti tpo levels were beyond 0000. It totally hampered my metabolism and i lost 17 kgs, hair balding, dry skin, teeth loss and shrivelled face. But every time the t3,t4 and tsh are normal. Doctors found vit d levels low and replenished it . for last 3 years have beeen on it and now at least mentally better. but digestion and bowel movement is horrible despite trying everything. what shud i do? do u think thyroid medication might help me to regain digetion and the full look i had prior to the acupuncture? Please help [/INST] **1. as you are on vitamin D therapy for last 3 years, make sure your calcium levels are not increased resulting in poor appetite (digestion/bowel)2. go for lab investigations first and then consult with your attending physician regarding further line of treatment. </s>

<s>[INST] Hi doctor, My grandmother is 72 years old. She is a diabetic patient. Her USG report showed SOL of a gallbladder. Please suggest. [/INST] Hi. I have gone through the attachment (attachment removed to protect patient identity). In the attached report, there is a space occupying lesion in the gallbladder. It has wall thickening. Usually, it is due to a large stone. But, no stone is seen in the ultrasonography images. Hence, it is advisable to investigate with a higher investigation that is CT (computed tomography) scan abdomen to rule out any tumor, if present. You can consult a surgeon for a physical examination. </s>

<s>[INST] Dear Sir, I want to know that can any person give his kidney to other person. because i want to give my kidney. I am working in pvt firm my body type is normal and i never admit at hospital. I am 27 years old my blood group is B+. My email is bhatt.jaimin@yahoo.com Please sir guide me. Thanking You, Jaimin Bhatt [/INST] There are tests to match your compatibility with the person you are donating. If you are medically fit without any pre existing problems you can donate your kidney in case nothing else is possible </s>

<s>[INST] I am a 47 years old female who passed a breast cancer treatment (surgery, chemotherapy and radiotherapy ), I have some dizziness and done MRI, the result is: Some T2 hypersignal foci are seen in deep and periventricular white matter and centum semiovale. This appearance is not specific but can indicate microvascular ischemic changes. Please help me to know what does it mean and is it serious or not? Thank you in advance. [/INST] Hi there, These changes may mean that the small blood vessels of brain have ruptured or clotted in very small areas. These findings are common in elderly population with longstanding hypertension or diabetes. Your dizziness may be explained by this finding. Seeing a neurologist would be a good idea, but important to control hypertension and diabetes if you are suffering from them.Take care </s>

<s>[INST] How serious is heel pain? I started having a sharp pain in my heel yesterday and haven't been able to put weight on it. I have elevated it some. It has been swolen, but I can't think of anything that could have caused it. I am a highschool athlete and getting ready for tryouts in 2 weeks and need to be well! [/INST] hai.in your case it can be due to excessive stress & strain on the heel area.please apply a cold compression two to three times dailythis pain is due to the irritation of the nerve endings.application of crepe bandage will be of good help.if the pain is not reduced please go for painkillers under medical supervision.take care </s>

<s>[INST] My Mum has been diagnosed with an anurism on her kidneys...4.1. She has to wait for a scan until December 2011. Is there danger of this anurism erupting at any time. What can she do to avoid an eruption? She is still having occasional cigarettes and is worrying herself sick. She is 77 years old and had a bowel/colon op 6 months ago which successfully got the cancerous tumour. [/INST] Hi and welcome to HCM.As an Urologist, i can understand your anxiety.A renal aneurysm can potentially have a rupture.This can be prevented by several techniques.She should stop smoking at once.As she had surgery for cancer colon,she needs to be examined by an Urologist and then do the following tests :Blood routine,creatinine,RBS,LFT,platelets,CT-IVU or a MRU.An abdominal CT scan and angiography is needed,with a chest X-ray.The aneurysm can be blocked by interventional techniques,using coils. </s>

<s>[INST] Hi doctor, I am a 49 year old female weighing 135 lb. I am a smoker, I have had a sore in the soft palate area from two months. Initially, my dentist gave treatment for an ulcer. But now it has recurred, and my dentist believes it to be a fibroma. I read fibromas do not usually appear on soft palate area. I have been referred to an oral surgeon for evaluation. My lesion is approximately 2 mm round and slightly raised, with minimal discomfort. I have attached a picture of my sore. Does it look like a fibroma? I am worried that it is cancer as I recently lost my husband to cancer. I am currently under tablet Crestor 10 mg twice a week, Baclofen, Propanol, and Imitrex for migraine. [/INST] Hi. For further queries consult an internal medicine physician online --> </s>

<s>[INST] i read some where that the body decreases in production of a certian chemical which may cause increase in blood pressure in the evening? Do you know what it is...or can you tell me what may cause increase in blood pressure in the evening? Even on bld pressure meds my bld pressure sky rockets at night. [/INST] hi XXXXXXX if u have increased BP in evening that is not normal but u should b sure about it n to b sure u have to do few things- is you BP machine is working fine- have you not done any physical exertion before checking ur BP- you don't have fever now if everything told above all are not with u and ur BP is high in the evening then u have to compare it with the morning BP n do it in a routine n make flow chart with time n dateincreased BP in evening can be due to-kidney disease -diabetes - nervous system problems - thyroid problems- cardiovascular disease n other contributing factors are:-night duties- tobacco/ caffeine use-stress- anxiety </s>

<s>[INST] hi. my son is 36 yrs old. he has had chronic pain in the lower right side of his abdomen for a few years. He has had all kind of tests ran. they have found nothing. now the symptoms include constant pain and for 3 days now he has been throwing up. He doesn t have insurance and cant afford another er trip or a specialist. but of he had an idea of what it might be it might help. also he has lost about 20 lbs in the last couple of months. I m sorry but I don t have the money. Sorry I bothered you. [/INST] dear friend don't worry. if all reports are normal no need to worry. but you should evaluate the cause of weight loss whether it is due to abdominal tb or other cause. if nothing then don't worry.your son's abdominal pain is of long term duration.so I suggest you for homoeopathy treatment .it is best in your case and has no side effect and also not much costly.take nux vomica 6. 6-8 drops in a cup of warm water twice a day. and then report me after 10-15 days.avoid spicy and oily food. take food at regular interval and time. don't eat much at a time.eat 4-5 times per day if much hunger but eat less at a time.hope this answer will be quite helpful to your son.for more queries don't hasitate to ask and don't worry about money.get well soon.dr.manu khimani </s>

<s>[INST] hi i am enquiring on behalf of a friends daughter who is in a very bad state at present, i actually drove over to see her and stay with her last night , she has a baby of 2years old, and she is only 21 years old herself, shes addicted to speed, aswell as cannibis, and also on medication for depression from her gp. The weight loss is drastic and she looks anorexic, she has scars resembling burn marks from where she constantly picks her face, she has a complete bald patch from where she constantly pulled bits out of her hair, her mother lives nearby but has recently given birth to twins, she is very manic with mood swings hyperactive breaking down constantly, and is not able to cope with anything, i managed to talk her into admitting she needs help and discussed options of getting her into rehab, i fear this is her only hope and fear if something isnt done quick, she wont be here much longer. [/INST] she needs urgent hospitalistion, and the diagnosis needs to be revised ....it seems she is having substance induced psychotic disorder or may be she is having schizophrenia. Talk to her GP and start her on antipsychotic medication and arrange for deaddiction treatment. Speed is a appetite suppressant and also long term use may cause sleep problems , mood swings and paranoid symptoms so she need treatment for amphetamines dependence and stay at rehabilitation center. </s>

<s>[INST] a 49yr.oldnman with no personal or family history of chd, and who is not hypertensive does not smoke. results: TCHOL=260mg/dL TAG=505mg/dL HDL=25mg/dL FBS=134mg/dL what is the LDL value using the friedwald and de long calculations? does the patient have a risk factor for CHD? enumerate them and explain why is it safe to report the derived value? why [/INST] Hiyes the patient is at risk factor for chd , his tg and total cholestrol levels aare elevated ,dyslipidemia is a very important factor for coronary artery diseaseCalculating ldl value using equations is a obselete process and there are many chances of error hence its not used these days , but as per your question val;ue of ldl is 140mg/dl according to equation.get a ldl cholestrol level done the patiient should start taking statins for 3 months along with life style modifications. </s>

<s>[INST] Hi im 23 and i was on depo provera on april of 2011...nd got really bad side effects 24/7...i was having these weird vibrations in my entire body as if i were having a seizure but was still consious...until now as of this year i kinda feel the vibrations in parts of my body including my head they are not as bad as they use to be...nd my question is if the shot is still affecting my body and can it cause some damage? [/INST] Hi No these is not side effect of drug, but apart from this the side effects are there of depo-provera, for to rule out the possibility of any CNS pathology or other metabolic disorder discuss it with your DOCTOR, Have nice day. </s>

<s>[INST] I underwent my 3rd vp shunt revision on 07-31-14.,I came home the next day with extreme headaches, confusion, memory loss, felt feverish, etc....notified neuro surgeon and he had me return to the ER the next day. Stayed in the ER for over 24 hours waiting on a hospital bed. Was finally readmitted and taken back to surgery and my entire shunt system was replaced. I was discharged home at approximately 8pm now yesterday. Upon arriving home began to experience fever, chilling, etc..... Had a low grade temp at discharge now fever over 100.3. Unable to reach my neurosurgeon and trauma center is 2 hours away. Unsure if I should try getting there now or wait until morning to call surgeon. [/INST] Hi,Thanks for writing in.There is a small possibility that you might have got an infection following revision of VP shunting surgery. Such infections are not common but should it happen then it needs to be treated at the earliest. Please take over the counter medication for fever like tylenol and then wait for about 4 to 6 hours to see for any improvements. If your doctors have given a course of antibiotics then please take it. You also need to eat well and take rest. If it is late evening and fever is 100.3 then you can still wait till morning but the first thing you should do is talk to your neurosurgeon if possible, any time before that. </s>

<s>[INST] Have been recovering from a bout with the flu the past couple weeks...........accompanied by COPD. Yesterday and today my stomach is bloated and my solar plexus area is sore to the slightest touch......as well as an "uncomfortable" heaviness in the chest area. Have been experiencing deep brochial coughing. Could I have pulled a muscle during coughing spell. [/INST] Hello dear, thanks for your question on HCM. I can understand your situation and problem. In my opinion you are having mostly GERD ( gastroesophageal reflux disease ). Uncontrolled GERD is the common cause for worsening of COPD. And chest heaviness with bloated stomach are the features of GERD more. But better to rule out cardiac cause first as COPD patients and at high risk for cardiac disease. So get done ecg. If ecg is normal then GERD is likely cause. It is due to laxity of gastroesophageal sphincter. Because of this the acid of the stomach tends to come up in the esophagus and cause the symptoms. So try to follow these steps. 1. Avoid hot and spicy food. 2. Avoid stress and tension. 3. Avoid large meals, instead take frequent small meals. 4. Start Proton pump inhibitors. 5. Go for walk after meals. 6. Keep 2 - 3 pillows under head in bed to prevent reflux. 7. Avoid alcohol and smoking if you have these habits. Don't worry, you will be alright. </s>

<s>[INST] I have had a burning, stinging rash around my mouth with swelling lips and tongue. It is painfully uncomfortable. It went away slightly but has returned full blast. It is also located on the chin in the crease, just below the lower lip. It is rough, and somewhat thick. I have had some anxiety this year with some life circumstances, frustration, and I most likely have not gotten enough water. My doctor says I;m at 60% and need to hydrate myself. I am not a nervous person, however, when a situation is frustrating where I am not getting answers or results it turns up the anxiety. I am looking for a remedy I can use as I am sensitive, and allergic to harsh things. I am on social security so can not do expensive remedies. [/INST] HelloAs you explain this might be a viral infection herpes simplex virus.Discuss with your doctorRegardsDr.Jolanda </s>

<s>[INST] I got a concussion week before last & am having a horrible time recovering. I ve been to the ER twice. I already suffer from vertigo and it made it worse. Fast forward to now... I have a constant headache, vertigo still high, although it has lessened some, nausea, vomiting, and today I noticed my eyes are red. I was prescribed zofran, meclizine, hydroxizine, & aleve. They don t seembto be working. So...my questions... are red eyes normal? and is there anything else I may try to lessen the symptoms I ve listed above? [/INST] Hi welcome to HCMI have gone thru your query regarding vomiting and vertigo in a person post a concussionDizziness ,nausea , headache , are other common symptom about PCS ,.Red eyes are not a normal symptom though , yet it is just a out come of your prevailing problems ,is not a cause of concern .Redness lie down will go automatically when you are free of principal symptoms . Meanwhile you 1. wash your eyes with cold water 2. lie down in a comfortable position , Take cotton pad dipped in cold water , squeeze extra water and apply on your eyes . It gives instant relief. repeat for 4-5 times . Resting will help prevent attacks . Lie down for a minute or two and close your eyes . This will allow more blood to flow to your brain. After lying down, sit up slowly and remain sitting for 1 to 2 minutes before slowly standing up. it is recommended that medications be avoided if possible . especially if they are not working .Side effects of medications may affect people suffering the consequences .Do not drive a motor vehicle, operate equipment, or climb on a ladder while you are dizzy.Do not lie flat on your back. Prop yourself up slightly to relieve the spinning sensation.Move slowly to avoid the risk of falling.Drink more fluids, especially water. Other fluids are also helpful, such as fruit juice . Lemon juice in a glass of water with salt and black pepper ,is a instant energizer and reliever of dizziness ..Avoid : Caffeine, tobacco, alcohol, and drugs that can affect your blood circulationDehydration which can cause or increase lightheadedness, when you have an illness that causes diarrhea, vomiting, or a fever , constipation ,sleeplessness ,worry ,anger .Modifying your life style and food habits by including ,essential nutrients - fiber ,vitamins mineral and antioxidants in natural form , advised by your qualified dietitian and regular exercise, yoga , Pranayam -Deep Breathing and Meditation under trained guide , will help long lasting health .Before applying any therapy in your regime , first talk to your doctor.If problem persist consult your physician . Hope this helps solve your query Take care All the best. </s>

<s>[INST] Hi im a 43 yo female with swelling in my legs and ankles for 5-6 months, I have r/o cardiovascular, renal, and rheumator factors. I have visit all 3 specialist and had multiple test ran and can t seem to figure out why my legs and ankles are swelling. I am not a diabetic I have never had any surgeries and serious illnesses and I get regular check ups, please help what do you think this could be? [/INST] Hi, Have you done your colour Doppler done? If not get it done to know the cause of swelling, needs to see your all tests to guide you properly. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Jaideep Gaver, Orthopedic Surgeon </s>

<s>[INST] Hello doctor, I am 31 weeks pregnant. I have been having contractions for six days straight now. They started at 20 minutes apart, then got closer. They have been two minutes apart lasting an average of 54 seconds for three days. They have not let up or have stopped. I went to the hospital and they said there has not been enough change in my cervix and sent me home and said not to come back unless I start bleeding. During the last checkup, I was 100% effaced, 2 cm, and 0 stations. I have been leaking clear fluid like crazy, but when I called they said it was probably a discharge. My legs and feet are very swollen. I know something is not right, but they refuse to run any tests because they believe it is false labor. What do I do? [/INST] Hello. Braxton Hicks contractions do occur about six weeks prior to labor but are generally not associated with effacement. If they were real labor pains you should have started fetal descent from 0 stations by now as well. Now, if the intensity of the pains are increasing between contractions then they are true labor pains and if not they are false labor pains. Ladies tend to gain weight because of hemodilution and edema in pregnancy i.e. swelling of the feet, it is a normal part of pregnancy. Leaking per vaginum is again significant. If it looks like water and starts suddenly, I would request you to reach the nearest hospital as soon as possible. I would finally suggest you meet your gynecologist and request NST (nonstress test) for the fetus and examination of the cervix. I hope this helps. </s>

<s>[INST] I ve been anemic all my life. I m 50 years old, still menstruating monthly but the the flow varies from heavy to clotting. Two months ago I collapsed/blacked-out. My family doctor ordered a blood count and my iron level was at 68, put me on ferrous sulfate 3x/day. He said it should be at at least 160. I had another blood work done last Saturday and now it has reached 90. What do these numbers mean? What s a good number to maintain? Is is the same level for all women across different age-group? My daughter is also showing signs of dizzy spells.. [/INST] Hello and welcome to HCM,Anemia is common in menstruating females.Blood loss during menstruation causes loss of iron and thus anemia.Iron deficiency leads to low hemoglobin and low iron stores in body.Your test report has shown low iron level in body.Thus, your doctor has prescribed iron supplements (ferrous sulphate).The treatment should be followed for atleast 3 months before improvement in iron levels can be expected.Get the iron test repeated after completion of iron replacement and consult your treating doctor with the results.If iron level has improved, the supplements can be stopped, however, if iron still remains low, iron treatment may have to be repeated.Thanks and take careDr Shailja P Wahal </s>

<s>[INST] Hello doctor,MRI scan on right ankle following a climbing fall of 3.5 m and hitting the ground, inversion rolling on impact. This was a year back ongoing pain and issues. The pain is around ATFL and joint and occasional swelling after heavy activity. I am a rock climber and train in the gym. I work part-time personal trainer so spend a lot of time on my feet, and also studying physio. The report and scan are attached, would like a second opinion as the scan is slightly subjective. I work in the sport and rehab industry. Please see scan images to see any issues, impressions are high grade 2 sprain of ATFL and CFL large tibiotalar joint effusion lateral malleolus trabecular fractures. I would like a new report, please. I need a second opinion 20 years old, 158 cm tall, 52 kg. Currently, I am taking Fluoxetine 20 mg daily for anxiety and depression. [/INST] Hi. The MRI scan images (attachment removed to protect patient identity) of your right ankle confirm the following findings: For more information consult a radiodiagnosis physician online --> </s>

<s>[INST] I believe that I have caught an infection that effects the nervous system. I was very mentally healthy and intelligent before this happened. I know exactly where it was caught, probably from coming in contact with infected feces. My family has a history of anyurisms. [/INST] Hello dear,Thank you for your contact to health care magic.I read and understand your concern. I am Dr Arun Tank answering your concern.Infection in the nervous system is not a simple thing. If you got this infection you won't be able to write it down this question also. So I don't think that you are having the infection in brain.But you should be investigated for the aneurysm in brain.I advice you should do brain MRI this will give a clue regarding your problem in brain.Your further management can be possible once you do MRI testing.I will be happy to answer your further concern on bit.ly/DrArun.Thank you,Dr Arun TankInfectious diseases specialist,HCM. </s>

<s>[INST] Hello doctor, I am having some pain on the head of my penis. Coupled with this is the fact that the left side of the head of the penis is red and inflamed. It is as if there is a small but extremely uncomfortable moving sensation within that area. I can actually feel the head of my penis acutely nowadays. I also feel a stinging sensation along the red inflamed glans of my penis. Occasionally, I feel a slight, stinging sensation on my scrotal sac and feel the need to scratch at that area. Recently, I have also been experiencing tiredness during the day when I am supposed to be working. I abstain from sex too. I am male, 25, and on no medications currently. [/INST] Hello. The lesions look like balanitis or rash due to infection. The most common cause can be skin irritants or allergy. Check for blood sugar, avoid allergens like deodorant or new soap or medicine. Use Candid B gel locally for one week. If symptoms are not improved, please consult your dermatologist or physician. He will examine and treat you accordingly. Take care. </s>

<s>[INST] My 13 month old daughter started having diarrhea today and then just a few minutes ago she had some more and it had like a pink mucus in the diaper...what does this mean? Its too late to take her to the doc tonight and I am freaking out so I just want to know what this could be..she doesnt have a fever [/INST] HI...please do not worry. It seems like a viral diarrhea. Unless there is blood in motion you need not worry.Once it starts it will take 5-7 days to completely get better. Unless the kid's having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry. There is no need to use antibiotics unless there is blood in the motion. Antibiotics might worsen if unnecessarily used causing antibiotic associated diarrhoea.I suggest you use zinc supplements (Z&D drops 1ml once daily for 14 days) & ORS (Each small packet mixed in 200ml of potable water and keep giving sip by sip) as hydration is very important and crucial part of treatment. If there is vomiting you can use Syrup Ondansetron (as prescribed by your paediatrician).Regarding diet - You can use cerelac...any flavour will do. Avoid fruit juices as they might aggravate diarrhea. You can give zinc supplements & ORS apart from normal vegetarian porridges & soups.Regards - Dr. Sumanth </s>

<s>[INST] Hi I had a mining accident in 2002. My ribs have been popping out of my back in the left shoulder blade area. Not one doctor has ever told me what it is. It s pretty painful and happens frequently. I had major shoulder surgery last May because the MRI was misread in 2004 and I have a neck injury also as a result of the fall. I fell sideways and basically tore everything. I was told it was Hypermobility? I have all of the medical reports as well to better explain. [/INST] Hello,Welcome to HealthcaremagicThank you for providing the brief history.As you have all the reports you can share the same in detailed so we can understand what went wrong. For now it looks that due to weakness in the muscles of the upper back there is malalignment or the ribs and have become prominent.With regular breathing exercises and stability exercise for the shoulder joint will help improve the muscle coordination and also improve the pain levels. Using cervical collar will be advised for the nerve injury to avoid stress and strain over the muscles.Regards </s>

<s>[INST] I am Male my age is 26 years old, i get married before one year, i didn t get baby, i go to doctor and he send me the lab and i give semen analysis: this is the result of my report please explain me and give me advance volume: 1.5 ml colour: grey white Appearance: Opalescent liquefaction Time: 30 Viscosity: thick Ph: 7.7 Total sperm count: 05 million/ml Active Motile: 40% sluggish motile: 35% non Motile: 25% pus cells: 10-12/HPF RBC: Nill/HPF Morphology: 45% Sample collection: inside the lab Opinion: Oligozoospermia. Dear doctor this is my result then my doctor send me Doppler Ultrasound. and the result was like this A moderate Varicocele is present bilaterally. the rest is normal. so he advanced me to go surgery what should i do? can you please help me what is the best way that i can get health fertility [/INST] hello welcome to HCM your semen analysis suggest a low count. \the motility is normal the doppler suggests a varicocele - usually if the veins are very much dilated only then surgery is planned. however the consultant has suggested surgery, hence he might have suggested it to you. if you do not wish to do surgery you can discuss with the doctor and they can prescribe certain medications which may help ( Co enzyme Q) if there is not not much improvement after medications,then surgery can be planned hope to have answered your query dr nandita thakkar </s>

<s>[INST] Hi my son fell and hit is head about 30 minutes ago. He has a big knot on his brow bone. Its a little purple not bad though. Its the hard knot that worries me.and he still has the imprint of the counter top.. he is acting normal but all of a sudden he is saying he is cold. Is this normal? Or do u think he needs medical attention? [/INST] Hello,Thank you for contacting me at "Ask a Doctor". I will try to answer your question to the best of my ability.It sounds as though he has a local contusion to the area. apply some ice, and give him some ibuprofen or Tylenol. If he has any signs of concussion such as dizziness, nausea, vomiting, drowsiness, etc., then you need to take him to the emergency room. I hope this information is useful for you. Please do not hesitate to message us back if you have any further questions.Best wishes,Adrian Rawlinson MD </s>

<s>[INST] Hello doctor,As I have PCOD problem and also cyst, I take tablets for period. My friend suggested Kalachikai powder. I used it for 30 days continuously, but no use. How many days should I take that powder and how to overcome this problem? [/INST] Hello. For PCOD (polycystic ovarian disease), powder Kalachikai has a good effect, but the duration of treatment is long (more than three months). For proper evaluation of disease, please go for USG whole abdomen and other investigations. If the size and number of cysts are more, then I suggest consulting a gynecologist as you may require surgery. If the number and size of cysts are less, you may continue treatment along with syrup Evecare 10 ml BD and Kanchnar Guggulu two BD. For more information consult an ayurveda specialist online --> </s>

<s>[INST] A week ago I hit the right of my chest right outside my heart with the sharp corner of a dresser. It was right between two ribs. It feels like I have a bruise and now my heart is in alot of pain. Almost a 6 or 7 on a scale of 1-10. Mostly hurts when I enhale. Can it be something serious? [/INST] HelloThere's no problem with your heart here--this is just a chest wall contusion although you may have a minor rib fracture.Since you're still having pain, let your doctor take a look and see if x-rays are in order </s>

<s>[INST] Hi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for annular bulging and tear? [/INST] Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online --> </s>

<s>[INST] I had a root canal two weeks ago after throbbing/hot and cold sensitivity and chewing pain in molar#3. 3 days later, the chewing pain came back and was still throbbing. One week after the root canal, I saw the endodontist again.She found nothing on the exrays, but opened the tooth and, in fact, found an infection and drained a lot of puss from the area inside the tooth. She didn t finish the root canal to be able to make sure it was healing. i was supposed to go back in two weeks. It has been one week, and the chewing pain has returned, throbbing continues and has moved to my lower jaw as well and all pain seems to affect #3 and the one in front and behind it. No visible swelling (though I was very swollen after the draining and am slightly swollen in the top front of my gums by the tooth). I am going back to the endodontist today. Is this possibly NOT a root issue and a bone issue? Nothing is showing up on the xrays, yet I am STILL in pain. New pain developed yesterday- at random (not eating or drinking or out in cold or anything) it feels like I am being stabbed in my teeth from the bottom up in random spurts of pain. What is going on? [/INST] Hello,Thanks for consulting HCMRead your query ,as you have pain in tooth and you are under root canal treatment but still you feel pain in tooth on chewing dont worry pain can be due to infection is still present in tooth , for pain I will suggest you to take one precaution is avoid chewing from side of rct treating tooth until root canal treatment is completed , and do luke warm saline rinses , inmeantime for pain you can take medication like Novamox lb , and analgesic like Ketrol dt . Hope this will help you. </s>

<s>[INST] Hello doctor I got dark spots on my two cins, as per doctor suggestion i am using Niltan SPF day cream and Dreamz ultra cream in the night. But now a days i am suffering from itcihng. Is the itching due to usage of these creams. Waiting for your answer [/INST] Hello dear and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice.The itching can be related to a side effect of the creams.It can be an allergic reaction to one of the creams or both of them.I suggest to stop using them for a short period of time.Meanwhile, I suggest Cetirizine 10 mg daily to relieve the itching.Hope I have answered your query. Let me know if I can assist you further.Kind regards!Dr.Dorina GurabardhiGeneral &Family Physician </s>

<s>[INST] sir, my uncles age is 80 years. sufferring with prostite problem and doctor kept separate pipe for urinating. from that day he is not taking any food and taking only juices and surviving on glucosebottles only.at present he is sufferring with loose motions.please suggest any medicine for fast relief please. [/INST] Hello, As I see the history it looks like the ageing factor and also some infection in the body. Since he is having loose motions this is due to the heat in the body. Which is good to allow it to pass on. Of course, there will be a fluid loss but too much heat in the body may not be good for the physiology to function. As prostate cancer does not lead to multiple troubles unless and until the grades are higher. This can be helped with medication and if required surgery. Also, you need to monitor the heart rate, blood pressure, oxygen saturation levels. Giving external oxygen supply through the oxygen saturation machine will be of benefit to help further. Control of blood pressure and blood glucose levels is also advised. Make sure he doesn't develop any respiratory issues as that may make him weaker. Giving a good diet which is kind of Gracy will be easy for absorption and also giving electrolytes will be good to have some strength. In bed, do some passive physiotherapy to help the muscular system to be active. As this plays a good role in bedridden patients. Also, see to that the catheter is removed after 2-3 weeks of time as this may not be good for the physiology to continue for a longer duration. Chances are heavy on the side of infection. Take the medication as prescribed by the doctor. Hope I have answered your query. Let me know if I can assist you further. Regards, Jay Indravadan Patel, Physical Therapist or Physiotherapist </s>

<s>[INST] Hi I have a poor left kidney function. It works only 10%. It is small in size measuring about 5cm. A replantation ureter was done 23 years ago because there was urine reflux to the both kidneys. Regarding the right kidney, it works well and measures about 9 cm. however, a uric acid stone was discovered in it. It measures about 1cm.The uric acid in the blood is high. It is 9.5ml. I started taking the uralyte four days ago and it seems to me that the medice is not working yet. My question is how long does it take for the medice to start dissolving the stone? Many thanks to you Doctor. [/INST] HelloThanks for query.You have poorly functioning left kidney and normal Rt kidney with Uric acid stone of a size of one cm.and have been advised to take Uralyte to reduce serum uric acid levels .It takes month or even more to dissolve the uric acid stone in kidney ..You should have patience and continue taking it Ensure to drink more water and take urine alkalizer along with Uralyte..Dr.Patil. </s>

<s>[INST] I self diagnosed my family for scabies after three visits to doctor over dry skin and possibly allergies. We used the Prometerin treatment two days ago. We are still itchy but I understand it will take two weeks to shed the bugs from our skin. My question is why are my thighs bruised. Am I itching that much at night and causing bruising? [/INST] hithis seems to be scabies with secondary bacterial infection , can be due to the itching or the lesions getting infected.application of 10% benzyl benzoate or permethrin is the treatment for scabiesit is better to meet your dermatologist, to add up with one course of anti-biotics to prevent the dermatitis or secondary infection.please do not meddle or scratch the infected area.all the besttake care </s>

<s>[INST] HELLO SIR, MY DAD HAS GONE THROUGH A SPINE SURGERY 6MTHS BEFORE DUE TO THE REASON THAT HE COULD NOT URINATE NORMALLY. AFTER A LONG TIME NOW HE CAN URINATE BUT WITH BURNING SENSATION. HIS CURRENT BLOOD TEST SHOWS THAT CREATININE LEVEL IS 1.6MG & UREA IS @ 36 PLEASE GUIDE ME FURTHER WHAT CAN BE DONE TO LOWER DOWN HIS UREA LEVEL [/INST] Hi and welcome to HCM. I am not sure why most questions are asked to male doctors only??? There are a lot of good female nephrologists and other specialists who might take offence if you guys keep addressing questions with 'Sir'!!! Jokes apart...... You have only given me a small bite of information which is insufficient to give any opinion. Only careful study of your dad's previous investigations and post op investigations will help us advice you the best course of action. Most importantly I need to know how well the bladder is emptying now which can be assessed by a blddder ultrasound scan pre and post void of urine. This is just one of the tests that will help me in giving you an advice. Best wishes, RB </s>

<s>[INST] I have a blotchy, sunburn-like rash covering my arms. It stings vaguely. I haven t been out in the sun at all and it doesn t itch! Any idea what it may be? [/INST] Hi..dear user.., Thanks for choosing HCM., Blotchy sunburn like rash on arms.., could be Nutritional dermatitis...it is causedby., Deficiency of NIACIN..,(Pellagra)., So follow., 1) Morning Calamine lotion ..on affected part.., it acts as soothing lotion gives cooling effect., 2) Night...Momentasome and gentamycin cream.., on affected part..ok., 3) Cap..Bcomplex and Zinc ., daily ., 4) Niacin tablets..ok thanQ </s>

<s>[INST] my son 8 years old is on risdone syrup of 2 drops every night he statred taking it 6 months back,i stopped it for 1 week on the advice of my doctor and he became hyper and stated beating and yelling everyone.can this medicine be stopped in the future? [/INST] Hi,Thank you for asking question on health care magic.If you want stop Resdone you have to withdraw it gradually.Abrupt withdrawl leads to complications.Hope this answer will serve your purposePlease feel free to ask any more queries if requiredTake careDr.M.V.Subrahmanyam MD;DCHAssociate professor of pediatrics </s>

<s>[INST] I was recently switched from bystolic to metoprolol tartrate due to a flux in insurance and reduced cost. Used to control blood pressure which has been benign ... now there is a flux with the m.t. they increased dose from 12.5 bid to 25 bid.... Is there an adjustment period? Should I be concerned? [/INST] Hi, i have gone through your question. I can understand your concern. but there is a adjustment period to set the dose of antihypertensive. Or switch from one group to othercgroup. You need to check it for sometime to set the dosage. So no need to worry. Once your blood pressure become stable with some dose. It will be fixed. Then also you should go for checking your blood pressure monthly according to your doctor's advice. So just follow the drug and dose. And go for regular check up. Hope i have answered your question, if you have any further questions or queries you can ask me for that. i will be happy to answer. Thanks for using health care magic. wish you a very good health. </s>

<s>[INST] I have a lump about the size of a dime and its oval shaped. Its right between my vagina and my inner thigh. There is no head on it and it isn t hard. It doesn t hurt unless I mess with it and its red. I don t know what to do because I don t have insurance to go to the doctor. How do I get rid of it ? What could it be ? [/INST] Hello and welcome to HCM,A soft lump between vagina and inner thigh could be due to enlargement of inguinal lymph node.A clinical assessment of the lesion is necessary for treatment.Thus, you will have to consult your doctor.In addition, an aspiration cytology of the lump is also required.Aspiration cytology is an office procedure wherein cells are aspirated using a needle, cells are spread on a glass slide and stained wit appropriate stain.The cells are examined under microscope.This investigation determine the site and nature of the lesion.Depending on the type of lesion, appropriate management is planned.Enlargement of inguinal lymph nodes is common after genital tract or urinary tract infection / inflammation.Thanks and take careDr Shailja P Wahal </s>

<s>[INST] completed 10 yrs on 28.02.11, Weight is 29 kg, height is 4ft6.5".One month before he suffered from Typoid fever and stomach problem.Again temperature remains more than 101 since last 3 days.Doctor tested Widal, blood routine,MPSmear Weil Felix.After seeing the report said that OXKis high & is 1:160 also ESR is 100mm/hr.Adviced to take Microdox-DT Tab in addition to Dibol syrup and Lanzol-15 tab. Temp.only in morning comes to 98 -100 degree.Child feels little pain in knees and around neck.Doctor said the infection of Typus Scrub, infected by insect's bite.Please advice how to minimise temp. and getting energy and feeling to have diet. [/INST] For typhoid fever your can give your son some antibiotic preferably ofloxacine and cefadroxyl after and expert advice along with ibugesic-plus or nimeson-p for high grade fever and body-ache. You can give him some multivitamins like syrup zincovit or syrup polybion once daily preferably in afternoon. Do cold sponging to reduce the temperature of his body. </s>

<s>[INST] After my 20 week ultrasound there were concerns about baby measuring small. Limbs (sorry, I don t recall the exact term) were in the 4th and 5th percentile, HC was 11th, and BPD was measuring in the 1st percentile. I was sent for a follow up ultrasound at 26 weeks. The numbers improved slightly with the limbs in the 8th and 9th percentile, HC was 18th, and BPD was at 4. My doctor is concerned, particularly with the BPD and has sent me for some tests and is referring me to a specialist. He also said I ll have more ultrasounds to monitor. Im looking for thoughts on what this could be. I just want to be prepared when I do get results back. I would rather worry over nothing than not be worried and have it turn out serious. [/INST] Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. The findings you shared are suggesting intrauterine growth retardation. In this condition there growth parameters do not increase as they should according the dates. One needs to look for the cause. Serial ultrasound scans are done to ascertain if growth is there or not. In case no growth is seen after specific time then doctor usually suggests termination of pregnancy. However, this decision depends upon strong evidence of no growth. Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing to us. Wishing you good health. </s>

<s>[INST] My brother had a mild heart attack three years ago at age 48. A stent was put in one artery. After the heart attack he didn't go to his Dr. to follow up and up until 9 months ago he was walking around with high blood pressure 180/115 (even on medications), he continued to smoke, he's 100 lbs. over weight, never exercises and he eats an unhealthy diet. If he continues this unhealthy lifestyle how long is this stent expected to work? [/INST] Hello.Depending on the type of stent, the stent can function for at least five years or longer.That said, if he continues his lifestyle like you describe, he will still suffer from further coronary artery damage and he will likely have another, more serious heart attack in the near future </s>

<s>[INST] I have either thin water,clear seman or yellowish.I have recently(within the last month)started massaging my prostate with hopes of doing something positive for that area.This started before my digital exam by urology.After the exam(same day)i experienced rectal bleeding that slowed after the first week.Now when i orgasm i either have thin,watery clear seman or with yellowish(urine colore).The muscle spasms are strong and i am worried that either i am peeing myself or have caused an injury.Please help [/INST] Thanks for asking in healthcaremagic forumIn short: Rectal bleeding is not a normal phenomenon unless you injure yourself by putting something there.Explanation: You might have started prostatic massage after urological examination. Please do send your age and problem for which you went for urological examination. If it is smooth, it will not cause injury and orgasms are strong after prostatic massage. Donot worry about semen, you can go for semen analysis, if its normal then no need to worry. </s>

<s>[INST] Dear Doctor, My brother son had adenoid, giving spray in night time. Due to child's mental and parent's worries, didi not like to go for surgery. But i also had the same idea not to go for surgery at this 5 years old boy.Preferring for alternative treatment for adenoid, could u suggest how to cure this adenoid problem of my brother's child by natural way of method by medicine or any physical breathing exercises [/INST] **1. What was the opinion of Child Specialist [also is immunization schedule complete till date] and ENT Doctor? [any associated enlarged tonsils/ pharyngitis]2. is he/she a mouth breather?? [since adenoids causes difficult breathing through nose]3. any change in quality of voice [nasal twang]?4. any problem of breathing during sleep [sleep apnea]?5. is child having low grade fever. not gaining weight or chronic anorexia, persistent dry cough [clinically or as questionnaire]i. Steam Inhalations 3-4 times a day.ii. Warm salt water gargles. [gargle with honey water]iii. avoidance of allergens [dust/cold drinks]iv. diet rich in vitamin C and vitamin E are rich in anti oxidants and thus helps in improvement of Thymus function (associated with Immunity.) Avoid: Heavy, slimy and acidic food, curd, mustard oil, excess physical exertion, sunlight-dust areas, exposure to strong winds, day sleeping, smoking, Potato, green leafy vegetables. Cold water/foodGive: Old brown rice, soup of moong dal, black grapes, cow’s or goat milk, garlic, lukewarm water to drink, black pepper, dried ginger, honey, mulethi, laungaPS. 1. In kids, adenoids usually begin to shrink after about 5 years of age and often disappear by the teen years. [have a second opinion]2. Recent large study showed, by laboratory tests and follow-up examinations, that children who have their tonsils and adenoids removed suffer no loss whatsoever in their future immunity to disease.3. since he/she is a kid thus may not be comfortable with Ayurveda Breathing and Yoga Techniques, please contact your Attending Physician regarding simple breathing exercises at his/her age.4. As the Age is above 3 years you can contact Ayurveda Physician there or an Ayurveda Hospital for “SUVARNPRASHAN” [64 drops (3 drops daily)] for a period of 21 days. [ stimulate body immune cells and thus protect child from different harmful organisms for a long duration] </s>

<s>[INST] I was on the pill called YAZ i was on it for 3 months, I missed about 1 week and i had unprotected sex in that week. I started spotting so i stopped taking my pill and the bleeding stopped however i am still bleeding very few days, Is there any chance i am preggz? or has the pill confused my body? I am having pains in my back, legs and belly my belly is tender to touch. Please advise me. Thankyou [/INST] Hello dearUnderstand your concern.Pregnanacy may be possible but chance is very less.For safer side confirm the pregnancy by Pregnancy kit 7-10 days after missed period .Or better to do Blood HCG level or USG that is very sensitive.Another reasons may be side effects of contraceptive pills like:Intermenstrual spotting, Nausea, Breast tenderness, Irregular periods, nausea, headaches or weight change, Headache, Malaise, weaknessWeight gain, Mood changes, Decreased libido, leg swelling and painAdvice:Take tablet meftal saps three times a day for 2-3 days or when painAll this side effects will decrease after regular use of pills as body get adapatedTake healthy dietAvoid excessive stress, alcohol, salt and caffeine.Do regular exercise.Use safer sex practice and maintain hygiene after and before sex.If persists , you can use other contraceptive methods like condomsHope this may help you.Best regardsDr. Sagar </s>

<s>[INST] Hi doctor, I have been experiencing some unexplained bruising for a few weeks. Also, last week I had a few pin point red dots on the side of my back which went away in about two days. This past week I discovered some more of the cluster of red dots on the back of my thigh, which turned into a big bruise the following day. Also, today I woke up with the red dots on the back of my other thigh. I had a CBC done today, but is this something I should be concerned about? I am not having any other symptoms. Would I be more symptomatic if I had a blood cancer? [/INST] Hello. Your symptoms are not suggestive of any blood cancer or other form of cancer. For repeated bruise and attached photo of lesion (attachment removed to protect patient identity) you have to investigate as follows: Liver profile reports to check liver pathology. CBC to rule out low platelet count, if present. PT, APTT to rule out coagulation problem if present. BT bleeding time testing to rule out vessel problem if present. After checking all these reports further work up can be planned. Meanwhile you can be prescribed oral Vitamin C tablet 500 mg BD for seven days. Topical Vitamin K cream application also can be helpful. You can consult nearby physician for detailed evaluation and discuss all these. </s>

<s>[INST] I had flu symptoms then came down with a bad sore and hoarse throat for 3 weeks, then I got a fever for a day and achy joints. I now have a rash on my chest that itches alot and my entire mouth is sore with a couple cold sores, my uper mouth seems to have lots of little sore bumps, almost like bubles that feel like cold sores. [/INST] Hi Dear,Understanding your concern. As per your query you have symptoms of chest rash and sores with itching along with mouth sores which seems to be due to impaired immune system after flu and medication after effects. Need not to worry. I would suggest you to drink plenty of water. Use oral numbing gel to avoid soreness of mouth. Keep chest area clean with soap and cold water and apply petroleum jelly. Apply moderately potent topical steroid of triamcinolone acetonide 0.1% cream twice daily at affected sites.You should visit dermatologist once and get it examined and start treatment after proper prescription. Hope your concern has been resolved.Best Wishes,Dr. Harry Maheshwari </s>

<s>[INST] I had slipt and fallen down and hurt my vertebrae about three of them perhaps. There was no fracture but since August this year its paining me. The pain has lessened down but my family doctor recommended various blood tests and they show that Im very deficient in folic acid and sodium too. I have been also put on tablets of Folvit too. Will the pain disappear over a period of time? Please do answer. [/INST] Folic did deficiency does not cause pain. But you could also be having Vitamin D deficiency which can cause pain. Get tested and treated accordingly. </s>

<s>[INST] my boyfriend is having a kidney cancer right now and i am afraid to lost him.can i give nutrilite protein powder for him,actually he already did the operation last year and the doctor took his 1 kidney could you please help me what am i supposed to do right now to help him still alive and healthy [/INST] Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. Nitrilite supplements can be given to a renal cancer patient. It won’t affect his health status and doesn’t interact with his routine medicines. The survival and prognosis will depend on the stage of the tumor. If the tumor is confined to kidney with out any distant spread, prognosis will be good. Hope I have answered your query. Let me know if I can assist you further. </s>

<s>[INST] hi, im a young basketball athlete who s life goal is to make it pro (19 soon to be 20) and i suffered for a looong time from jumper s knee in both legs... as you most likely know this is a chronic injury that leads to the degradation of the tendon (in my case it was in the lower pole of the kneecap, due to overuse, and i played 2 years with it) my doctor was amazed i could stand all that pain for so long, but well i did, untill my leg started giving way and i stopped... conservative treatment didn t work, especially for the left one, which had the most damage and some torn fibers, so i had arthroscopic surgery for debridement and im 2 months post op, i can walk run etc, but hte pain is still there at a lesser degree while it would be ok for a sedentary person, my goal is to make it back and be able to get to my old standarts without pain and build up from there... physio has helped, but it didn t get me where i wanted, and i don t think it will now (judging from the right knee s results) my options, thus, are these... 3 injections prp in each knee (controversial info all over the web about it, but two of my three doc s are SURE it helps with tendinosis) and then eccentric training to strenghten up the new collagen and make my knees as brand as new... or at least it should work like that second is peptide therapy (cjc1295 and ghrp2) plus some intravenous concoctions that are supposed to help A LOT (all the results and evidence in here are anecdotal, from both the web, and guys i know that pointed me to this biologist who does this, who works with proffesionnal athletes and has quite the name here in greece) and finally, the bodybuilder s way which is taking deca durabolin in maintenence doses plus proviron-cialis to be sure my endogenous testosterone produccion will stay safe and anavar as a main anabolic, and train low intensity, high volume, especially eccentrically, just as i would without them but adding the weight to my training periodically in that monthly-cycle now, i don t want to be chastised about ANY of these ways, as i am ready to take the risks... i want to take it to the end, either play basketball or nothing... and i will do ANYTHING... i need some words of advice, any doctor s word that has any evidence of any of these working or not, would be greatly appreciated, but i would like the REASONS behind your responses! thanks in advance and sorry for the long post [/INST] Hi I have read all the details you have given. In my opinion since Jumper's knee is a overuse injury causing damage and degeneration , newer therapies like PRP ( Platlet Rich Plasma) are to be preferred mainly because they have the regeneration potential and virtually no side effects. Decadurabolin- I would not recommend at all due to long term side effects. I do not know much about peptide injections . </s>

<s>[INST] i have a sudden swelling on my forehead since a week. First it looked a bit like a rash. I went for a facial and she said it was a whitehead and said she took care of it. But the swelling remained thought it decrreases everyday. Now its barely there. But it kind of pains inside. Theres also two red bumps on my eyebrow [/INST] Hello and welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. It may be due to pimples and there is pus collection inside, which gave rise to nodule like appearance. Nothing much to worry and you can apply Clindamycin ointment for symptomatic relief. If the swelling persist for long, you can go for laser therapy, which has got good results in similar conditions. Wishing you good health. Thanks. </s>

<s>[INST] Hi. I got my wisdom removed Friday evening due to an infected wisdom tooth. I'm worried about getting dry sockets. I also noticed that it still looks infected even if my molar was removed. My doctor gave my antibiotics. Is it normal for me to feel/see the stitches move? When will I know if I have dry sockets or not? [/INST] Hi..Welcome to HEALTHCARE MAGIC..I have gone through your query and can understand your concerns..As per your complain it is normal to have some pain and tenderness at the site of wisdom tooth extraction for a period of a week to even ten days..Stitches can at times move or fall off if not placed properly..As it is about a week of extraction, and in case if there is no severe pain then the chances of dry socket are less as the dry socket generally becomes symptomatic after 5 to 6 days of extraction and is a severely painful condition..I would suggest you to go for a clinical examination and get evaluated and if there is tissue filling the socket then there is no dry socket formation and the extraction site is healing well..As of now you should do warm saline gargles, gargle with antiseptic mouthwash and maintain a good oral hygiene and keep the extraction site clean..Avoid putting tongue again and again at the extraction area..Hope this information helps..Thanks and regards.Dr.Honey Nandwani Arora. </s>

<s>[INST] my newborn daughter was born with hypoplasia of the 2nd and 3rd toe. Both of those toes are much shorter than her other toes. One of the toes looks like a little nub and the other does not have a normal nailbed. That nail is growing sort of like a cat s claw, just straight, she has no nailbed. What could be the cause? Also what type of surgery could be done? I was thinking plastic surgery or maybe inserting a piece of silicone or something to lengthen the toes... [/INST] Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. Do not worry. This can be corrected to some extent once child grows up by plastic surgery.Hope I have answered your query. Let me know if I can assist you further.Take care.Regards,Dr. Archana Verma </s>

<s>[INST] Hello doctor, I was born with a structural birth defect where my left hand is completely deformed. My left arm is normal from the wrist and above. I would like to know if this defect is hereditary if I try to have a child. What are the risk for me as a father passing any defects to my future children? [/INST] Hello. I can understand your concern. It will be of great help if you can send me the picture of your deformity. I will be happy to help you further. </s>

<s>[INST] HI, Recently I noticed a Small BB sized (or smaller) bump Inbetween my scrotum and anus closer to my scrotum, and it is deep under the skin, cannot see it. and when I push hard on it I feel pressure, It also moves around, I am going to get a physical but before I do I would like some suggestions, i am very worried and do not want it to be cancerous. Please help. [/INST] Thanks for asking in healthcaremagic forum A bump may be just a cyst/boil/neurofibroma. If may not be cancerous. Please do not worry instead visit a doctor/surgeon for exaination and further management. All the best. </s>

<s>[INST] Hello doctor, I am 65 years old, 173 cm height, 84 kg suffering CAD, HTN and DM type 2. Having three stents and still PLV 90 % blockage. On tablet Atorvas 20, Starpress XL 50, Nitrofix SR 30, Telma 40, Dianorm-M and injection Lantus 24 u. But due to angina or short breathing, tablet Flavedon MR also started for three weeks. Now I am feeling well. Whether all three tablets are necessary for angina? Please guide. [/INST] Hello. Yes, you will need all tablets, as they have an additive effect. Other two antianginal like Starpress (Metoprolol), has many beneficial effects other than this, and decrease mortality. So it needs to be continued. Also, Nitrofix (Isosorbide mononitrate) is also important and needs to be continued, otherwise angina will recur. You should have a healthy lifestyle like avoiding fatty, oily and high-calorie diet. Have low salt diet and monitor blood pressure regularly and BP should not be persistently more than 140/90 mmHg. Regular exercises like brisk walking, jogging according to your capacity at least 30 minutes a day and five days a week. Lots of green leafy vegetables, fruits, fish once or twice a week, avoid meat. Avoid smoking and alcohol, if any. </s>

<s>[INST] Hello Doctor, Myself sonakshi and I have a son who is more than 2 years old. When he was just 7-8 months old a white patch suddenly appeared on his forehead, then i have been started a homeopathy treatment for this patch.The treatment is still running from around 1 and half years . Even sometimes it shows clearly and sometimes it shows light. Kindly suggest me what should I do now and what should i take the precautions for him specially in foods? [/INST] dear parent, this could be due to a fungal infection or vitamin A difficiency to differentiate an examination is required. vitamin A is treated with vitamin A supplement. fungal infection is treated with an antifungal medication </s>

<s>[INST] Hi doctor,I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for annular bulging and tear? [/INST] Hi. I have gone through your query with diligence and would like you to know that I am here to help you. For further information consult a neurologist online --> </s>

<s>[INST] My office has been painted for three weeks now. People have suffered dizziness here and there. Twice I got lightheaded and felt tingles. The first time my right leg tingles with dizziness. The second time my left tricep tingled with dizziness. Both bouts lasted less than a minute. Then once getting out of my car several hours after work I have very short duration dizziness and very light tingling in right arm. That lasted maybe ten seconds. Could these symptoms be caused by paint fumes? I am 53 years old, five feet four inches tall, 165 pounds. Overall health is good. I take one to two Lodine per week for hip arthritis. [/INST] Respected user, hi I evaluated your query thoroughly.Yes certainly if it is happening only after painting of the office.Hope this clears your query.Thanks for using Health care magic & reviewing my answer thoroughly.Regards dear take care. </s>

<s>[INST] my dad has to have posterior cervical decompression surgery this minth. I am worried because he nis a heavy smoker and drinks at least 3 beers a day. will this make his healing and recovery a slower process/ Should we get another opinion on posterior ve anterior surgery? [/INST] Hi there, thanks for your question. Smoking definitely has direct relation to healing after surgeries. It can affect wound healing. particularly with reference smoking has been associated with non healing of bone referred to as non union or non fusion. It is highly advisable to quit smoking. Regarding anterior or posterior surgery it is always worthwhile to take a second opinion before going under the knife..All the best. with regards. </s>

<s>[INST] hello my name is esther. i have been taking the microgynon 30. today makes it a month. for the past 4 days i having been having pain while and after urinating. and i cant sleep at night. please do you think its because of the drugs. please reply. thanks [/INST] Hello,Microgynon does not commonly cause painful urination. The symptoms can be related to an urinary tract infection. I suggest to do a urine test to confirm the diagnosis and take proper treatment. Meanwhile, I suggest to use spasmolytics to treat the pain.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 had strep throat 2 months ago, shortly after treatment I began getting small round blotches in various areas of my body. I was given a 3 day prednisone pill hoping it would clean, however its still here. Its not itchy but it is very disturbing nothing I ve tried is helping. What could this be? [/INST] Hi, Could be a viral exanthem. I suggest you use a soothing lotion e.g calamine lotion. It is soothing and drying. In addition, I suggest you take an oral antihistamine e.g Tab Cetrizine once a day for a few days. Hope I have answered your query. Let me know if I can assist you further. </s>

<s>[INST] I get my blood tested every 6 months because I take meds for Cholesterol. In Sept 2011 my SGPT was 17. In Feb 2012 it was 23 and then in Aug 2012 it was 47. The doctor didn t test for it in Sept of this year. Should I be concerned about liver damage. [/INST] Hi and welcome to HCM Thanks for the query. This is still just slightly elevated SGPT and it doesnt indicate serious liver damage. however,you should do frequent lft check ups and liver ultrasound just to prevent some suprises. also,chacnge your dietary habits and avoid alcohol and hepatotoxic drugs.Wish you good health. Regards </s>

<s>[INST] hi !! dr.. am staying in thane.. my father is pateint of hepatitis B, can you suggest me Dr's name in thane . 2) q. this is the serious case or wht ? can you explain me ? [/INST] Thanks 4 ur reply..My dr. said 2 my father he having a Heptitise B+, this is the very first satge but, i want to just ask u..is this very serious ? can we do the treatment on that ? how long is the tretment etc..pls. explain about the same one. </s>

<s>[INST] I am not epileptic; I am bipolar, type 1 with psychosis (possibly schizoaffective instead). I stopped taking my medicines on Sunday night. I missed, among others, my keppra (off label), trileptal and lithium. I take 1000 mg keppra BID; 300 mg trileptal AM, 600 mg trileptal PM; 300mg lithium BID. While I have had definite positive effects, my brain just did something weird. It, well, pulsed. I just took all of the above drugs. I see my doc tomorrow. He does not know I did this. Am I OK? [/INST] DearWe understand your concernsI went through your details. I suggest you tell this to your doctor and get his idea. There should not be anything wrong with it.If you require more of my help in this aspect, please use this URL. Make sure that you include every minute details possible. Hope this answers your query. Available for further clarifications.Good luck. </s>

<s>[INST] Yesterday I lifted up one side of a pool table very heavy later that night my back and my upper stomach was hurting just went to store and it hurt to lift a can of cokes. And I could barley talk an it hurt to walk. Michael. Thanks I did not know I had to pay. I have health ins. If I don t feel better it go to doctor [/INST] Hi,It seems that you might be having back muscle strain and spasm of muscles giving this problem.Take Diclophen with muscle relaxant medicine for 2-3 days.Apply some muscle relaxant, analgesic cream locally.Take rest and avoid doing heavy work for few days.Ok and take care. </s>

<s>[INST] Hi I had a frenuloplasty 6 days ago and I hadn t noticed any bleeding since the second day. I ve been bathing every pulling the foreskin back to clean the area and today I noticed a lot of blood compared to previously their are also white patches along the stitches line which I m assuming is normal. Was just wondering if I should still be bleeding after 6 days or not?? [/INST] Hi,Frenuloplasty is the release of a fold of skin on the underside of the penis. It is done to decrease pain during sexual intercourse. A dressing is not necessary, but it is normal for the wound to bleed or ooze slightly for a few days. You can have a shower after 24 hours and usually a dressing in not indicated until your inner clothes are getting soiled.Usually it stops bleeding 2 - 3 days after frenuloplasty as mentioned by you. The bleeding on day 6 can be falling away of the scab. This is a single event and one must not worry. If it bleeds continuously then it can become a concern and you must talk to your surgeon. </s>

<s>[INST] My daughter has a weakening pain in her left forearm......she is left handed, works daily on the computer and also paints intricate pictures in her spare time. At times she has twitching muscles in her arms and legs on occasion. She is very worried, has had a recent cold that she cannot shake off and has a cough. She is off her food and is very low because of this. [/INST] It may be due to some stress and anxiety common in children for various reasons.Anyway consult a physician for loss in appetite and muscular twitching.serum calcium,sodium, potassium, Vitamin D andB12 levels need testing.high protein diet and fruit juices </s>

<s>[INST] Hi, i just have 1 quick quesiton please.. For a while now (at least a couple of years), i've been experiencing a little bit of heaviness in the center of my chest, it sorta feel's like a small weight is just sitting on the top of my chest. I went to the hospital last year for it & they didn't do much for me. I'm constantly pressing my hand to my chest to get some minor relief. Should i be worried? [/INST] Hello, Thanks for posting your query on Healthcare Magic...* Brief Answer: chest pain or heaviness is a bit of concern.*Explanation: My opinion is that chest pain or tightness has a lot of differentials, but most important thing to exclude is ischemic heart disease, you need to check for that with your physician , also other causes are gastritis , esophageal spasms, , musculoskeletal , etc. I suggest my patients the following : detailed medical history regarding risk factors, electrocardiogram, some labs like cardiac enzymes, lipid profile.The information provided by you is not sufficient to provide a good opinion. If someone comes to me with this condition I would ask them about others comorbidities like diabetes hypertension , etc. also details about characteristics of chest heaviness.*Conclusion: I suggest you check with your physician. If you have any further questions I will be happy to help, If not, you can close the discussion and rate the answer. Wish you good health. </s>

<s>[INST] My son had recently had a blood test, he is 13, and his liver enzymes were high. He is on two type of mood medications, the doctor said that these medications are not responsible. We were told it is possibly "Gilbert syndrome". He also has dry patches on his back, toes and above his elbows. [/INST] liver enzymes are elevated because of gilbert syndrome. consult a gastroenterologist for the treatment of gilbert syndrome </s>

<s>[INST] Hello doctor,I have dry gray spots. After sunbath I got this and is uncomfortable while reading. [/INST] Hello. I understand that you are concerned. But the picture attached is quite blurry. Kindly send a clear and well-focused photograph to help you better. </s>

<s>[INST] Hi, I was just curious in my case. I have this very small spot in my lower right lung when I had my x-ray for my medical but as I remember, I had my x-ray way back in my college days but there was no spot found. The doctor said that I need to see a pulmonologist to examine my x-ray result. My mother said that I had my medication in my lungs when I was a child for about 6 months. I'm a bit scared if it's contagious did it already affect any person I'm with? [/INST] Thanks for your question on Healthcare Magic.I can understand your concern. This recent spot on chest x ray was not present in your previous chest x ray (during college days).So you should definitely concern about this. So consult pulmonologist and get done clinical examination of respiratory system and CT thorax.CT is far superior than chest x ray to evaluate such spot. If it is mass like lesion then biopsy is needed to rule out cancer. If it is infectious then bronchoscopy is needed to identify the infection. Don't worry about spread to others. First diagnose yourself and then start appropriate treatment. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. </s>

<s>[INST] I am 38 yrs old and recovering from a myomectomy to remove three submucosal fribroids with the largest at 6cm. My gyne told me she saw scar tissue and removed a small cysts from the left ovary. i had a lap done in April of this year in which and the fibriods could not be removed but a cyst was removed from the left ovary. I am now being told i have a 10 percent chance of conceiving. My concern is after the lap I was told she used the blue dye and my tubes were clear and if I didnt want to conceive right away to use birth control. I dont understand why the change in being told that now there is an issue with conception. I still had scar tissue nothing really had changed. [/INST] Hello,Thanks for sharing your health concern with us. I have gone through your query and would like to offer some suggestions. Considering your age, the ovarian reserve is more important to plan mode of pregnancy. In addition, scarring has been noticed repeatedly and this is not a good sign. In view of all these findings, your doctor may have opined so. I would suggest ART since precious time is wasted trying for natural conception. Hope you find this information useful. Take care. </s>

<s>[INST] My son is going to be 16 in 20 days. He said that while sitting at school his heart started beating fast and he felt tightness. It happened before and he said it felt like heartburn. He's also been having knee pains. Which I think it's from jumping a wall onto the pavement to go to school. [/INST] Hello!Thank you for asking on HCM!These symptoms seem to be related to anxiety. Does he have any bumps or swelling in his knees? An immunological disorder affecting the joints and the heart could mimic this clinical scenario. I recommend consulting with the GP for a careful physical examination, a resting ECG, a chest x ray and some blood lab tests: - complete blood count- PCR, sedimentation rate, fibrinogen- liver and kidney function tets- thyroid hormone levels- anti streptolysine O titer - blood electrolytes. If all the above tests result normal, the most probable diagnosis would be just pure anxiety. Hope to have been helpful!Best wishes, Dr. Iliri </s>

<s>[INST] My son was given and antibiotic after running a high fever for almost 5 days. They tested him for strep and it was negative but the prescribed him an antibiotic anyway. He is still running a low grade fever after having 3 doses of his antibiotic do you think there is something else going on? The antibiotic he is taking is azithromycin. [/INST] Hello,This is Dr. Klarida Papaqako answering your question.Fever is a symptom that indicates that an infection is going on in your son's body. Azithromycin is a very good medicine, and it works for lots of bacterial problems, but people may also be resistant to it, or there are also problems who may not be covered by it.The fact the its not working after the third dose, means that one of the above options is possible, and you need to consult your doctor again, so he runs another check up, does other labs, and gives the proper antibiotic that your son is sensitive to.Hope this helps,Take care. </s>

<s>[INST] sir, i have urinary infection pus cells r numerous after treating with ofloxacin 200 i went again for uti checkup at that time epethilal cells 3-4 hpf if it is dangerous iam getting this infection 2 or 3 months intrevell. i have 4mm calculi in right kidney and 3 mm in left kidney is it cause kidney problem. my mail id YYYY@YYYY . pls advise me at the earliest [/INST] Hi Bigkrishnan,Thanks for writing your query.Recurrent urinary infection can be due to stones in the kidney.It is advisable that you consult a Nephrologist / Urologist for treatment of kidney stones and get Culture and Senstivity report of your urine to know which antibiotic is suitable for your infection. Drink plenty of pure filtered water. This will help you in both- kidney stone and urinary tract infection.If possible please mention or upload your urine report.I hope this is helpful to you.Thanks. </s>

<s>[INST] Hello I am from india. My nephew is 7 yr old wight 20kg. he is suffering from cough and our doctor priscribed medicin montel LC kid and ABphylline and omnacortil 10mg. and also a syrup asthelin.. is it correct to give him these medicin.. doctor did not advice for Xray and he is telling that my nephew is having asthema but he is not having any trouble in breathing. should we continue these medicine??? plz suggest me.... [/INST] Thanks for your question on Health Care Magic. I can understand your concern. Omnacortil is steroid. And steroids when given systemically can cause many side effects. Side effects are more when it is given to children. So better not to give oral steroids in children. Inhaled steroids are safe and can be given to children without any side effects. So in my opinion, you should consult other pediatrician and don't give these drugs especially omnacortil. Hope I have solved your query. I will be happy to help you further. Wishing good health to your nephew. Thanks. </s>

<s>[INST] Hello,Doctors : I have Question to ask, Me and my husband make love in my 13days after my Period for example my Period came at Aug3 and then we make love at Aug15, and we do widrawal but he take a bit long have contact or he take a bit long inside of me is there some posible or chance that i will get pregnant, FYI we dot have any kids yet and i am 28 years old, I will apreciate some responce, Thank you so much and have great day, My apologies my English is not that good ;) [/INST] Hello dear.I understand your concerns.yes dear, there is chance of the pregnancy because you did sex in the ovulatory period.If your period will delay by the 8-10 days then go for urine pregnancy test and or blood HCG to rule out the pregnancy. Hope this will help you.Thanks.Dr.sagar </s>

<s>[INST] i have a hard pea sized lump on the left side of my neck it can hurt when touched or stretching ive also been getting headaches that feel like someone is squeezing my head and at times i get these sharp pains in my head that only last for a couple seconds any ideas what this could be [/INST] Hi,Dear,Good Morning from India.Thanks for your query to HCM Virtual Clinic.-I studied your query in depth.I understood your concerns.-In my opinion-you may be suffering from-lymphadenitis or boil in neck.-From the facts given from your query,I feel your lump is with systemci symptoms of headache and could be due to tonsillitis with neck lymp-adenitis.Clinical examination from Surgeon would fix yor worry.-Hope this would help you to discuss with your doctor on your visit.Wellcome to HCM again for any more queries.Have a Good day. </s>

<s>[INST] I have had my wisdon teeth removed since i was about 17 years old, beings they would have pushed into my back teeth, & because i have overly crowded teeth! Now my back right tooth has a whole right above the tooth at the gumline which is draining pus constantly, and no matter how many times a day i brush my teeth, my mouth has a foul taste! Does anyone know what this could be?? [/INST] hiwelcome to HCMFoul taste or helitosis could be because of pus discharge from the teeth.for this you need to get IOPA xray done which will reveal the cause of pus discharge.this pus discharge might be because of underlying infection inside gums or abscess formation.visit your dentist and according to xray finding, get your treatment done.thank you </s>

<s>[INST] Hi, I have been off the depo shot for 1 month now and have been trying to get pregnant.I have not had a period yet and am now this past month I cry about anything and have acid reflex and heartburn all the time. I just took a pregnancy test at the doctors and it was neg. Should I go back and get blood drawn? [/INST] Hallow Dear, Pregnancy test on the urine before you missed your period is rather too early and is sure to report (false) negative results. This test should be performed about a week after missed period to have reliable results. In fact, it is advisable to let a period of about 3 to 6 months pass after discontinuing Depo contraceptive to attempt for pregnancy. It may take some time for your menses to get regularised. You may take some proton pump inhibitor preparation like pantoprazole for your acid reflux and heartburn. It will give you some relief. For your over reactions to the adverse things, please report to a counsellor. Too much of stress also is responsible for delay in menses. If at all you want the results of urine pregnancy test to be confirmed, you may opt for Beta hCG test on your blood 10 days after the last unprotected intercourse. Dr. Nishikant Shrotri </s>

<s>[INST] I have a small bump towards the back of my vagina inside the whole. it started a few weeks ago & my doctor told me I have a UTI & im in antibiotics for it. my boyfriend got checked for stds & he has nothing & I haven tslept with anyone else. it burns my vagina when I pee but otherwise there is no discomfort. please help. [/INST] Hi! Good afternoon. i am Dr Shareef answering your query.Burning sensation while passing urine might be due to a urine tract infection, which could be detected by a urine routine, microscopic and culture sensitivity test followed by appropriate antibiotic for a cure. Apart from this you have to go for enough of liquid and water in your diet. However, the bump inside your vagina might not be related to the UTI and it could be an independent pathology by itself. It might not be possible to opine on it without a clinical examination, and so I would advise you to get it assessed by a gynaecologist in your area. I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. Wishing you an early recovery. Dr Shareef. </s>

<s>[INST] Cervical Problem - pain in C1 to C7, mainly in C7 Hi have a pain sever pain in my neck..c1 to c7...it gives sounds too when I move it semi-clock or semi-anitclock wise....please suggest....it's almost 3-4 years to this porblem... [/INST] It seems a chronic problem.you will need a Orthopaedician who can physicaly examine you cause that is what i did when i had this chronic problem of back pain. He put me under some medication and also demonstrated some exercises which are very helpful till now. </s>

<s>[INST] Hi I have miserable misalignment syndrome in my legs and I have a corrective surgery 2 years ago. The plate and 8 screws they put in to hold my bones in place after is causing me a lot of pain. So my question is should I leave the plate and screws in or can I have them removed [/INST] Hi, Usually, it's not required to remove them until unless they are causing a problem. You need to get yourself properly examined if they are the main culprit of your pain. If yes then it's better to get them removed. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Anuj Gupta, Spine Surgeon </s>

<s>[INST] Two days ago, I begin experiencing extreme pain in the hip/gluteus maximus area. It s tough to sleep and walk, or even sit. I ve used a heating pad and have taking motrin in an attempt to provide relief from the pain--to no avail. The only physical thing I ve done in the past two days is get in and out of the car. What could be the problem? Also, might it be something I should get medical attention for? [/INST] Hi,You may have pulled your gluteus muscles during some strenuous hip flexion activity. So I suggest you to sleep over your stomach, don't walk too much and take rest. You may opt for in home physiotherapy sessions as in physio there are various machines like (ift, tens and heat therapy which will give you pain relief). If it doesn't get better with 5 sessions then do visit your orthopedician.Hope I have answered your query. Let me know if I can assist you further.Regards, Dr. Harsh Swarup </s>

<s>[INST] I tend to forget things and misplace my personal items and also day dream too much. My mother was diagnose with Bipolar disorder. I am just 18 years old and I hate it when it happens that I lose something or cannot focus because I think of so many things at once. What can it be? [/INST] Hi dear,Thank you for your query.what ever you describe about your self is suggestive of depressive disorder but without proper history and mental status examination it is difficult to diagnose.As your mother is suffering from bipolar disorder so it might be possible to have hereditary psychiatric problem.so need to evaluation is necessary.Consult psychiatrist for it.Thank you </s>

<s>[INST] Hello,I am a 29 year old female diagnosed with Transverse Myelitis in 11/12. I am waiting to get a biopsy done to confirm Neurosarcoidosis. I am going currently going to Johns Hopkins. My doctors are very busy and don't have much time for me. When I got the information about Neurosarcoidosis, I had lots of questions, but was too upset to ask them. So, here goes...Is there any other drug to treat this besides Prednisone? I am currently taking 60mg a day(I did some research and came up with Imuran) Your thoughts???Is this something that could be passed to my child?If there are crystals on my spinal cord, can they be surgically removed?Where on earth did this come from? The only issues I have had recently was a viral infection in 8/12. [/INST] HIThank for choosing HCM, I think the final diagnosis is yet to be confirmed, and you might given a steroid on basis of clinical history alone, after final diagnosis with help of MRI, spinal tapping, it is extremely necessary to differentiate the diagnosis, careful evaluation needed of full central nervous system, with routine investigation, to rule out the under laying possibility of infection either viral or bacterial, chances of finding of the etiologic causes is uncertain sometime, time is very much crucial in this regard, in time and early diagnosis, increases the chances of rapid recovery. Here is answer of your queries====1> yes there is another treatment available beside the steroid, "Plasma exchange" can be try along with steroid or followed by steroid it depend upon the exact pathological changes,and over all experience of physician. 2> No it is not contagious disease it wont pass to your child, 3> the chances of formation of crystal, you are thinking is rare and even if it is there it wont causes any clinical symptoms, because the area is already under attack and clinically manifested. 4> Many of Pathophysiological script comes with human being and becomes the cause of illness, and death, at any time during the course of life. Do not worry you will come out of this very soon,Have good life. </s>

<s>[INST] Hi, For a while now I keep getting a red blotchy rash all over my chest. It only seems to occur when I eat hot food, I get nervous in a situation like interview for instance or if I drink alcohol but sometimes if I just change environment it can occur. It flares up for about 20 minutes then goes away. Are there any treatments I can take for this as it is really affecting me now. Thank youAlice [/INST] All the triggers that you mentioned are situations where the body interprets as a condition of stress(hot food, Anxiety, Alcohol, Environment). The exact mechanism for a stress related rash or urticaria is still unknown. However anti-histaminics do help along with treatments that would lower your body's response to stress. These include relaxation techniques(You can try yoga and deep breathing) and incorporating exercise in your daily life as it would modulate your response to stress.Thank you for your query. </s>

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

<s>[INST] i suspect I had eaten an apple bitten by stray fruit bat due to ignorance yesterday ie., 4-1-2011. though I had chopped the bitten part and also washed fruit in water, what are the chances of my getting infected with rabies . I am in Sudan where there is literally no health care [/INST] Dear Friend, . Only Vampire bats can transmit rabies The chance of getting rabies by taking fruit bitten by bat after washing is practically nil Contact me for more information or guidance Wish you Good Reproductive & Sexual Health With Warm Regards, Dr. A CHAKRAVARTHY MBBS; MBA; (MHSc Reproductive & Sexual Medicine) Consultant, Sexual Medicine / Sexologist, TRIVANDRUM, KERALA Email: dr.a.chakravarthy@gmail.com +91 – 944 77 050 77 / 94471 55 0 77 / 99 464 2 55 77 President, International Association of Sexual Medicine www.drchakravarthy.com / www.sexual-medicine.org </s>

<s>[INST] Hello Doctor, I recently did Hair Smoothning for straightning my hair, the results are good but what care should i take to maintain it?as i have been aked not to apply oil for the next two months. I am 30 years old,5.6 is the height & i weigh 75kgs.Thanks. [/INST] Hi, Hair straightening is not permenant. It will remain till new curly hairs grow. You may apply oil on the straightened hairs,if you wish. Actually oiling the hairs will enhance the improvement in softness of the hairs. You should avoid frequent direct shampooing the scalp. Mild shampoo..herbal in nature and diluted in water twice week should be done. Almond oil may be used,as it contains vitamin E.Hope for the good result..Thanks.Dr.Ilyas Patel MD </s>

<s>[INST] I just came home from the hospital due to chest pain so the Doctors did all the tests for my heart which came out negative which is good, however; I have noticed that when I m sleeping my heart will race which wakes me up and then I feel pressure in my chest. Can they run all these tests that come out negative and I still have a problem because I feel the same chest pressure before I went in. they gave me nitroglycerin and beta bloskers so of course my heart was ok in the hospital? [/INST] Hello, Heart palpitations are indicative of Arrhythmia, arrhythmia may lead to either fast or too slow heartbeats. If left untreated it may complicate to Atrial fibrillation, Flutter or Supraventricular Tachycardia (SVT). The cause is commonly hyperthyroidism, diabetes, mental stress, smoking, excess alcohol intake, etc. Pressure in the chest or squeezing crushing pain is the symptom of angina, caused due to reduced blood flow to the heart muscles. Avoid tobacco use, maintain blood cholesterol, blood sugar to the normal levels. Stop smoking, maintain a healthy diet, avoid addictions if any, alcohol & stay away from stress. Get all lipid function tests, stress test, Holter test, ECG, Echo done. Your treatment will depend upon the pathology detected. You may get treated with medications, cardioversion, ablation therapy or coronary bypass surgery. Get treated at the earliest to avoid acceleration of your symptoms. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Nupur K, General & Family Physician </s>