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<s>[INST] I am 70 years old I am on blood thinners earlier this morning I was getting out of my vehicle and the door came back and hit me on the elbow it is swollen about the size of a golf ball and it is purple and black what could be the cause should I see a doctor [/INST] Hi there In my opinion Purple and Black colors indicate internal bleeding since you are on blood thinners , you will need aspirationalso there is the possibility of crack fractureuntill you see your doctor or get admitted to ER use ice packsGood Luck </s>

<s>[INST] Hi doctor, I had sex for the first time. After that, I did not get my periods yet. I went to a gynecologist. She had taken my blood sample and it was negative. But, still I have not gotten my periods and it has been a week ahead. What could be the reason for my late periods? [/INST] Hello. As the serum beta hCG levels are less than 3 mIU/mL, the pregnancy is definitely ruled out. The delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves. The menses can get delayed even up to two weeks, so just wait for another week and they should arrive. If not, then you can safely opt for a progesterone withdrawal to resume menses. For further information consult an obstetrician and gynaecologist online --> </s>

<s>[INST] my b12 was low at 245 and i have infertility issues because of it including a miscarriage at 6 weeks in 2009 it is not diet related i got put on cycobalmin tablets which didnt increase it so my doctor doubled them it only raised my b12 to 330 i was told to stop my tablets and see if my body could keep it up but it has fell back down to 240 so was wondering if the injections would be a better choice than the tablets i am 28 female 4 foot 10 and 8 stone 5 [/INST] Hi, dearI have gone through your question. I can understand your concern. You have vitamin B12 deficiency. You may have some problems with absorption of vit b12 from gastrointestinal tract. You injectable vit b12 is the better choice. You should take a course of injectable vit b12.Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health. </s>

<s>[INST] I had a roux en y done 2003. Lost from 400 down to 194. Lost ins but maintained weight until about 2007 wwhen I was slowing down due to balance issues & numbness in left foot . Diagnosed in early 2009 with progressive ms. Doing okay so far with ms but weight up yo 270. Experiencing some abdominal-left side pain, nausea & vomiting off & on. Would I be candidate for revision? I did have gallbladder removed & have 2 ulcers . Thank you [/INST] HIThank for asking to HCMI really appreciate your concern looking to the history given here I could say that you have a multiple disease and in such situation developing some functional elements is very likely and I guess this is what happening to you, in my opinion you need to keep the stress level very low, and stop worrying about this every thing would be alright, take care and have a nice day. </s>

<s>[INST] Hi doctor, I am a 26 year old male. I am 5 feet and 9 inches tall and weigh 255 pounds. When I eat spicy food, I poop blood. Sometimes when I have constipation as well, I poop a little bit of blood. I am really scared that I have colon cancer. I do have diarrhea often. I do not have a family history of colon cancer. I got blood tests done last night. Please find my reports attached. [/INST] Hello. I have gone through your information and test reports (attachment removed to protect patient identity). So, in view of that, there are a couple of things that I can opine upon: Hope that helps. For more information consult a general surgeon online --> </s>

<s>[INST] Hi, I tested at a 1.57 creatinine level and my doctor had me return to the lab and the second test had a level of 1.84 (blood). He immediately made an appointment with the nephrology department. My urine creatinine is 35.4 and was part of the 2nd lab visit. I am 52, 160 lbs. and believe myself to be in good health, I have high blood pressure but it is well controlled. Should I be concerned? Is my doctor being cautious or are those numbers alarming? I understand the blood test range tops out at 140 so test 2 is welll above that. I appreciate and look forward to an feedback. Thank you in advance. [/INST] Hi,Thanks for writing in.The creatinine level in blood shows the ability of the kidney to help in filtration of blood. The normal creatinine level in blood is less than 1.3 in most clinics. If your creatinine level in blood is 1.84 then it is increased. This can mean that the kidney filtration rate has decreased with time. A nephrologist is the specialist in kidney disease and they will evaualte kidney function in detail and suggest investigations like urinary protein, creatinine clearance and if required then a nuclear scan based on your clinical symptoms and medical history.Occasionally food habits can cause increase in blood creatinine level and this is to be discussed. Research shows an increase in serum creatinine can result from increased ingestion of cooked meat (which contains creatinine converted from creatine by the heat from cooking) or increased intake of protein and creatine supplements, in excess of the recommended dosage and therefore requires you to talk to your doctor. Please do not worry. </s>

<s>[INST] Hi, mayHey there! I am a gay, me and my mate have a daily penetratHey there! I am a gay, me and my mate have a daily penetration, he cums inside me...my question is, if i have hommeroids and his sperms goes inside my blood, will my immunity system consider semen as a intruder and fight it then,if yes, what about the semen which is in my body(my testicles), will be fought as well? thank you I answ [/INST] Hello, Sperm cells can not penetrate your blood vessels and it will not survive in blood also. Nothing much to worry about it. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Shinas Hussain, General & Family physician </s>

<s>[INST] Hi, may I answer your health queries right now ? Please type your query here...hi I'm 24 and apart from the odd cold and chest infection I'm generally well, I have a daughter who is 3.I have been separated from my girls dad for 2 years and have been with a bloke now for nearly 1 year and a half years.my new partner works nights and stays over mine on his two nites off. About 3 weeks ago I started becoming afraid of going to sleep, I'm terrified some one is going to come and take or hurt my daughter. Its getting worse, I don't sleep till 5 am and often get in bed with my daughter. I shake and if I hear the slightest noise I freeze, my chest tightens and I panic, its getting so bad I'm phoning my boyfriend every night to come round to check the flat, some times more than once a night. I was thinking back and its not just at night I feel like this, if I get on a bus I'm ok till it moves. I get so scared I want to get off. I went to my doctors who have just stuck me on zopiclone. I feel like I'm going mad and people are laughing at me. Why do u think I'm like this and what can help ??? [/INST] DearWe understand your concernsI went through your details. I suggest you not to worry much. Panic attacks always happen due to underlying anxiety. Therefore you must address the underlying anxiety first. Please understand anxiety and related problems. Once you understand your anxiety, you will be able to keep yourself away from panic creating situations. Therapy always starts with avoiding such situations along with coping techniques when forced to be in such situations. Start slowly, progress gradually, attain neatly.If you require more of my help in this aspect, Please post a direct question to me in this URL. Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques.Hope this answers your query. Available for further clarifications.Good luck. </s>

<s>[INST] I have found several pea sized moveable lumps around my groin area, also I have two large lumps that are paralell to one another. They have been there for years and the Dr. said not to worry about them. I am just now finding nore of them and have realized that there are 6 smaller ones around the area. I am very scared! Help! I am 27 years old, normal height and weight. [/INST] Hi ,they are either Lipomas(fat globules) or lymph node swellings.If you are worried you should get examined by a Surgeon. Without examining you it is very difficult to say what it is.If they are Lipomas then they do not need any treatment. If troublesome you can get them removed by a small surgery and will need to consult a Surgeon for the same, Take care,Dr Rishi, New Delhi, India. </s>

<s>[INST] Hello doctor, I am a 31-year-old male with a history of closed globe injury in the right eye 10 years ago. At that time, my vision in the right eye was hand movements only and I was diagnosed with a macular injury. Three months later, my vision slowly improved to 6/36. However, my right eye started to deviate (exotropia) and I started experiencing diplopia. My main problem is diplopia. I have used prisms, but of no use. When I try to focus on an image, I have severe diplopia. The diplopia disappears when I try to correct the squint. At present, I am doing higher studies and the diplopia is really bothering me. Will doing a squint surgery be of any use? Is there anything that I can try? [/INST] Hello. Diplopia is occurring definitely due to squinting because, in this, the image which is formed will be defocussed. It has occurred secondary to the trauma. The only remedy is to correct it by surgery. If it would have been due to other causes which were intrinsic to the eye then the chances would have been to correct by glasses. But still, I would suggest you get to check whether the diplopia is due to the squint only and even after surgery your vision will not recover however the diplopia can be relieved. For more information consult an eye care ophthalmologist online --> </s>

<s>[INST] I m 25 years old.Married.I have got a rash type of Acne in my face since last week.I ve had it before two weeks back, then I was asked to get Microdox dt for 6 days(Doctor s Opinion) with Acne Aid Soap, immediately my rash was healed. But now it has appeared again.My face is itching also.It has become dry and reddish(infected Area). Kindly let me know what I can do for this.earlier I had a clear and good skin. [/INST] Hello.You shouldn't be stoppin antibiotics till your doctor tells you to do so, usually for 3 to 6 months.You will also require anti acne creams and emmolients.Stop Acne aid bar if it is causing dryness and irritation. </s>

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

<s>[INST] Hello doctor,My mother is suffering from acute severe asthma for the last five years for which she is regularly taking treatment. But, from 10 days she felt some pain in her stomach and there were lots of red dots on her feet and back. Today, we visited a doctor who performed some tests. I am attaching the reports of the same. Kindly advise us on this. What is wrong with her? [/INST] Hello. I went through the reports (attachment removed to protect patient identity). These are called as purpuric rashes. There are a number of causes for this. Was there any fever? Where did the rashes start off? The probable diagnosis given was a meningococcal infection. This can be treated. There is no need to worry. There seems to be thrombocytosis and excess platelet count. Did she have these complaints even before? During this, was she alright or a bit drowsy? What was her consciousness level? For more information consult an internal medicine physician online --> </s>

<s>[INST] I just did an MRI of lumbosacral spine and it indciated L5/S1 caudally migrated central and right-paracentral posterior disc protrusion indenting the thecal sac and entrapping the preforaminal segment of the right S1 nerve root. I need to understand what that means? and whether this is curable using medication and physical therapy or do I need a surgery? [/INST] Hello!My name is Dr. Aida and I am glad to attend you on Healthcaremagic!These MRI findings are indicative of degenerative changes in the lumbar spine intervertebral discs (bulging) that lead to compression of the nerve roots which originate in this region, probably causing irradiating pain in this region (in the sacral area). Do you experience pain in this region? Physiotherapy and medication (painkillers, muscle relaxants) can help improve the situation. Surgery should be discusses as a treatment option, only if physiotherapy and medications fail to improve the situation. Hope you will find this answer helpful!Best wishes! </s>

<s>[INST] sharp tingling pain on the top of my left foot, darts of pain, swelling like a lump. some tingling in the toes and up the back of the leg, pain like muscle pain in the calf of the left leg, walk lame, cannot put pressure on foot like lift under gate with left foot, cannot kick football with foot [/INST] If you live in a cold reagion maybe ist reaynodBut you also have to check for gout and about some.nerve entrapment but there is so little information. </s>

<s>[INST] I am a63 year old female, 15 years post op from lamenectomy L 3&4, 4&5 & S1 compromised. Initially the surgery was effective, but now do suffer from lower back pain . Night time sleep is interrupted due to left leg and foot spasms. I take 5 MGM Diazapam to settle. Am quite concerned as I am experiencing dizzy, balance and coordination promblems associated with an altered gait. Could this be the result from the Diazapam. Hope that you can help me? Have had blood tests, ct of middle ear , physio treatment, eyes tested, nothing shows up. Am not on any other meds. [/INST] Hi, you had laminectomy 15 years back, Now suffering from the lower back pain, taking diazepam 5 mg, Now you are suffering with dizzyness , altered gait. Tests done every thing is normal. You are suspecting it to be due to the diazepam. There could be another reason, like atherosclerosis, ischemia of the brain, or some thing of that sort. I advise you to consult a neurologist for diagnosis. Thank you. </s>

<s>[INST] Dear doctor My mom has liver cirrhosis due to Hep B. Unfortunately, my native country (mongolia) we don't have antiviral medication to slow down the disease process as well as the sclerosis. How I can get medication without prescription ? I tried the canadian pharmacy but they need also canadian doctors prescription. Please help me [/INST] Hello and Welcome to ‘Ask A Doctor’ service.I have reviewed your query and here is my advice.In liver cirrhosis, to reduce portal hypertension and to relieve edema, Diuretic and Beta blocker like medicines can be prescribed.Anti-viral medicine is given only if active stage present with high liver enzymes, more viral DNA marker, and HBeAg positive.This medication is given on prescription of the registered medical practitioner in most of the countries. Consult a nearby physician for examination and your further work up.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Parth Goswami </s>

<s>[INST] Hello, I have a quick question. Last tuesday I went to the gym and ran did some walking, speed walking and then running for the first time in years. I only ran for a couple of minutes as my body isn't used to it. Since that work out, almost a week later, I am still experiencing a little pressure in the centre of my chest. On the weekend I had a little burning which has subsided. Should I be concerned or should I go see a Doctor? I am 35, about 175lbs, 5' 11" I also just had my period and have been very tired this past week too. [/INST] Thanks for your question on Healthcare Magic. I can understand your concern. By your history and description, possibility of GERD (gastroesophageal reflux disease) related symptoms is more. Your symptoms are more with periods. So possibility of stress related GERD is more.GERD is due to laxity of gastroesophageal sphincter. Because of this the acid of the stomach tends to come up in the esophagus and cause symptoms of central burning chest pain. So no need to go to hospital at present, first follow below mentioned things. 1. Avoid stress and tension. 2. Avoid hot and spicy food. 3. Avoid large meals, instead take frequent small meals. 4. Take pantoprazole tablet on empty stomach. 5. Go for walking after meals. 6. Quit smoking and Alcohol if you have these habits. You will mostly improve with all these in 1-2 weeks. If not Improving then consult doctor. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. </s>

<s>[INST] Hi doctor I am trying to conceive and my doctor recommended me to take ova shield on the third day of my period. I am also having pcod. My last period was on 13/1/2018.nom i am having slight stomach ache and tenderness in nipples is there any chance of getting pregnant? [/INST] Hi there, I have understood your concern and I will suggest you the best possible treatment.First of all do not panic.As you might be knowing that missed period is the most important sign of pregnancy.I will suggest you to wait till your expected date of menses, if you happen to cross your dates then please get morning's first sample tested for pregnancy. In case of any doubt, blood beta HCG test and USG will be of help.Ovashield is combination of essential vitamins and minerals that help to improve fertility. It is not a direst egg formation medicine.Besides, as you have PCOD issue, please opt a healthy diet and regular exercise regime. Drink plenty of water. Include more portions of fruits, vegetables and salads in diet.Start on Folic acid and Vitamin B 12 supplements regularly. This helps to prevent various problems during conception, pregnancy and delivery.I hope this answer helps you.Thanks.Dr. Purushottam Neurgaonkar </s>

<s>[INST] Hi, I sustained an injury to my lower back, left leg at work a year ago, other than 12 approved visits to physical therapy no other treatment has been done. They send me to different state doctors, which usually perform the same tests or questions, however this doctor measured the circumference in three locations on both arms and legs, without checking my back or leg at all I don't understand? But the measurements on the right arm and leg are larger on both the right leg and arm, I use a cane on the right as well. Thank you for your time [/INST] It is normal to have right side larger (no idea why they did this measurment)any way your physical therapy program should include streching of your lower back and strengthing of the abdominal muscles also streching of your iliopsoas muscle is recommended Good Luck </s>

<s>[INST] I have ankylosing spondynitoss and I need a doctor in Schenectady ny I have been takeing oxycodone 5 mg for about four years now it helped me get going in the mornings my body is stiff and a slow starter when I get up .well any way I need a new doc my last doctor can,t see me any more can you help am out of meds sence the end of last month . [/INST] Hi, It appears that you have reached the 2nd stage means the dose of the drug stopped working, now you can try increasing the dose. I advise you to consult an orthopedic surgeon for diagnosis and treatment. I to my patient with such symptoms prescribe injections of vitamin B1, B6, and B12, for 10 consecutive days and to be continued 1 injection every 10 days. along with the other medicines. Thank you. </s>

<s>[INST] My 1 year old wakes up between 2 and 4 every morning, screaming and crying, and does this for 30 minutes to 3 hours. She does not get a bottle at night, i ve given her a night light, toys, comforted her, let her sleep in my bed, let her cry it out (is what happens most nights) music and she also sleeps with a fan for white noise. We have ruled out night terrors. Nothing has worked, she still wakes up screaming. I have been trying to pinpoint what is triggering it. I have noticed that when she sleeps on her stomach (which is 99% of the time) she screams, the few times she has slept through the night (in 4 or more months) it has been when she has stayed on her back. I am out of answers...and ideas. I am starting to get worried that this isn t just a phase or stage and that there is something more serious going on...help? [/INST] Nothing is serious about thisAt this age this pattern at night seems quite common, there can be multiple factors for this like night terrors, hunger cry, thirst, parents anxiety etc. none is related to any illness. For this you can try one solid feed following water before a sleep , and try to give water without awakening in between the sleep if accepts. Your problem can be solved. Also at this age during sleep (lying position) in some children acid regurgitate and comes in throat from stomach which is irritant can make child irritable this will resolve after an age. if it causes more problem can be treated with an tire fluxes medications. </s>

<s>[INST] Hello doctor, About six weeks ago, I started to have vision problems, and I had a migraine. So I went to my pediatrician and got an MRI because they thought I had a tumor. I then went to an ophthalmologist, and he said I have pseudotumor cerebrai. I got a spinal tap done, and all the results came back negative. The doctor told me that it might be due to the birth control I use. Kindly advice. [/INST] Hello. Birth control pills with estrogen are an established cause of such a condition. In pseudotumor, all investigations are normal, just like in your case. Hence it is called as "pseudo" tumor. The next important step is to meet with your obstetrician and change the type of birth control pills you are on. Your ophthalmologist or physician may start you on oral medications to reduce the swelling of your optic nerves. The other important measure to reduce the severity of your condition is to get your body mass index (BMI) within the normal range. BMI is a simple but effective tool to monitor how healthy your body is in terms of fat content. I hope this helps you. </s>

<s>[INST] Hi doctor, If my complete blood count has high RBC value and low MCV and MCH values, what is the possible diagnosis for me? [/INST] Hi. Hope this will help you. Take care. For further queries consult a hematologist online --> </s>

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

<s>[INST] My 5 year old daughter had fever for last 3 days , I was giving her meftal syrup and cepodem 100 for her cough. Today, though she doesn't have fever, the cough seems worse and she is not able to sleep with the constant coughing. In fact she puked twice and took out a lot of phlegm. She also has a runny nose. Please advice what can I give her for the cough , will sinerest help? [/INST] hello, Has she ever had wheezing earlier? I think with the upper respiratory tract infection still laryngeal oedema and other upper airway oedema has not settled. That is why she is having severe cough. Only having antibiotic is not enough. She needs bed rest, an antihistamine like loratidine, small amout of bronchodilater like terbutaline, and a steroid likw dexamethazone. plenty of warm water and gargling throat using pinch of salt added warm water will also help releving cough quickly. If your daughter is a wheezing better to nebulize once and give child the loratidine, terbutaline and a steroids.also. It is ok to give sinerest to releieve nasal congestion. Hope tthi s helps. thank you. </s>

<s>[INST] Female 52yr, 5ft4 160lbs have fibroid in uterus, but normally very healthy, I ve been experiencing sudden onset of Severe!! Pain in my upper left Shin, no warning when resting, sitting, or standing, no particular pattern, no warning stabbing pain hits..feels like nerve pain, just under the skin under left 3in under left knee on top of shin, the pain is EXTREME comes last about 3-30 sec(the longest 30 sec) same spot each time, can come one day 2 time short sec. leave come back day later or next. Also experiencing feeling like little worm crawling under skin on left calf. [/INST] Hi,thank you for providing the brief history of you.A thorough clinical examination is advised.As you are 52 years old, there might be some degenerative changes in the spine and this might be leading to pinch of the nerve as well and this might be the cause of the pain which comes and goes without any prior signs.Also, getting a thorough assessment should help understand the nature of the pain better. Also, with physical therapy exercises for the core stability and pelvic floor strengthening you should be better.In my clinical practice patients coming at this age with fibroids and sudden onset of pain, most of them have pinched nerve and post physical therapy they all respond well.RegardsJay Indravadan Patel </s>

<s>[INST] my sister age 35 years sufferring from severe backpain from 2 years and now she could not able to get up. she is in rural place , doctor told to some tablets and told it will cure in another 2 months, but patient should take bed rest, doctor told that some pus is formed on the backbone you should not journey and take complete rest untill it is cured [/INST] HiThanks for posting your query. There are many causes of chronic back pain but only few will cause inability to walk . If your doctor's diagnosis is right then she needs to be admitted and given injection not just tablets. If you have any reports of her kindly upload so that i can go through and advise better. If none done its better you get MRI lumbar spine and revert back . Any clarification feel free to ask . Regards. </s>

<s>[INST] Just recently I have experienced numbness in the front of my left knee. It will come and go almost instantly (2-3 minutes). I thought it might be cold weather but after feeling my knee-cap, it was warm. It felt as if it was cold; like I was cycling in cold weather. My knee does not hurt. I do a lot of walking/hiking/cycling. [/INST] Hello, It could be peripheral neuropathy.Consult a neurologist and get evaluated. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician </s>

<s>[INST] I saw my dentist today who said he has never seen lumps like the ones I have at the back of my tounge. They are not red or painful, just raised. I do have acid reflux and take prilosec daily. I have had a lap band for 5 years and have had 2 endoscopies in the past 6 months. I have a bitter tast in my mouth that never goes away. I am 50 years old.and am in menopause. [/INST] Hello, Thanks for your query.Bumps on back of tongue are known as papillae & they are natural. In case they are painful & inflamed,then it can be due to various reasons:- -trauma -allergy -canker sores -throat infection -leukoplakia -scarlet fever You need to rule out the exact cause by visiting dentist & get it treated accordingly. For temporary relief you may apply topical anesthetic gel like dologel 2-3times a day. Consult your dentist in case problem persists.I do hope that you have found something helpful and I will be glad to answer any further query.Take care </s>

<s>[INST] Where can I find a chart of liver enzyme test results that show what s high? Like if its this high you need a liver transplant or you can get on medication to lower levels? My fiancé has Acute Liver Failure and I am trying to get this information for him. He has Hepatitis C from drinking, He has stopped but I think it s too late but we need more information on this. I asked my family Doctor and the lab tech at the local hospital and they said they don t know. [/INST] HelloThanks for asking query on HCM. One cant take a big decision like liver transplant just based on few blood tests and there cant be a one cutoff level. One has to see patient in total, his condition, complications, etiology along with lab reports. Usually we use some of the derived scores or criteria for prognosis and treatment purposes like - MELD score(for CLD), King's college criteria for ALF. Please meet your liver specialist doctor and get evaluated and then he will guide you regarding further managment.Take care </s>

<s>[INST] My ten yr old son has been on vyvanse for approximately 4 weeks. He seems to have become more anxious and has displayed moments of anger. This is not his general behaviour. He has a computer at school and today he was so angry he threw it on the ground.....very odd for his to do this. He is on vyvanse for in attentiveness at school. Can you tell me if this behaviour. Could be as a result of vyvanse Thank you Michelle [/INST] Hello Welcome to Health Care Magic Vyvanse is a good medicine for ADD. It belongs to amphetamine group. As you have mentioned that he has recently shown episodes of anger. He even threw the computer on ground. It may occur either due to poor control of his ADD or due to some mood episode. In a number of patients of ADD mood symptoms may develop. They may show anger outbursts, irritability, arrogant behavior. I will advise you to take him to Psychiatrist for proper evaluation. Medicines like Sodium Valporate which is a mood stabilizer can be given in such cases to decrease anger and aggression. Thanks Dr. Seikhoo Bishnoi </s>

<s>[INST] Hey Doctor, I got chicken pox when I was very young around 6 or 7 years old and I got shingles when I was around 34, now I'm 62 I started experiencing the same kind of nerve pain since 8 years ago but no blisters. My son told me and consulted our doctor to get gaba pentene which reduces the pain. Do you think is the pain due to shingles? [/INST] Answer: Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. Shingles is a viral infection of the nerve roots.So,yes nerve pain can be a symptom of shingles.Proper treatment can avoid chronic pain in this case.Hope I have answered your query. Let me know if I can assist you further. </s>

<s>[INST] Hello docor,i am a boy 14 years old,when I masturbate sperm leakage will continue for more than 25 min,please say any remedial measures for this,please(i am ready to stop masturbation when you say)-please give me more points about this :)I am really worry about this. [/INST] DearWe understand your concernsI went through your details. Sperm production happens whenever you are sexually excited. If your body is producing sperm, your body is responsible to throw it out also. Because sperm is a waste product for body, body throws out throw its own means. Those are automatic processes and you do not have any control over it. Your present problem, 25 minutes sperm leakage, episode could have happened only once and that is not at all worrisome. May be you are exaggerating what happened. What leaked could be your urine. Don't expect that to happen again. You are just 14. Don't unnecessarily dwell and be obsessive into these matters. Please concentrate on your education and career.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] Hello doctor, my brother had fever 7 days ago. He took many antibiotics (augmenten, ceftriaxone) and antipyretics but the fever come again. widal test was done and salmonella typhi O is positive titre 1/160 and salmonella typhi H is positive titre 1/80. also Liver enzymes ALT and AST were testes and they were very high (216 and 144).what should we do? [/INST] Hi The above stated test result is suggestive enteric fever, but if the test is done with rapid slide method then it should be repeated again with the tit ration method increase level of Liver enzyme is nothing to worry in infective state of body this enzyme tend to increases, initially your brother had been given antibiotic erratically which brings drug the resistance among the bacteria this is mistake done, now he should be given floroquinolones (ofloxacine 600mg twice a day) along with the chloromphenicol 500 mg thrice a day for six days keep good hydration state . Get well soon </s>

<s>[INST] Hello Doctor, am an asthmatic and want to know if frequent urination is connected to an impending asthma crisis. I notice I always have this occurrence just towards a major attack (about 2-3weeks).I am 30years old, male, African, and been diagnosed with asthma for 15years now.Thank you. [/INST] Hi,Frequent urination is not a known precipitating factor for asthma.If the frequent urination is a regular occurence the it needs to be evaluated by a physician to rule out other causes like UTI, Diabetes, etc.RegardsDr. Mishra </s>

<s>[INST] My 21 month old son vomits quite often. it usually begin with him coughing a little then having projectile vomiting. He is continuously mucousy even with humidifiers, steamed bathrooms and saline spray. We thought that the mucous was the cause of his vomit, but then he also vomits sometimes when he s in the car, or runs around too much. When i brought this up to his pediatrician they assured me it was because he has a weak stomach or because he just gets too excited. There is no fever or any other issues after he vomits, he doesn t seem cranky after wards and he doesn t even cry. His vomit looks like ricotta cheese chunks with lots of fluid. [/INST] As per you give detail in your history that your child vomit with cough or when he run around too much or in car. i want some more information. since when he having these symptoms ? what is frequency of this symptoms ? does he have recurrent cough? Two possibility in my view. more chance that he is cough problem . for that if symptoms are so frequent we give medicine so that problem control. other possible she has more acid production if stomach , for that i would to give medicine which reduce the acidily like lanprazole . so if was your treating doctor i would to have more detail for proper treatmentwith you healthy life. </s>

<s>[INST] I have numbness lower annulus and down left hip/leg to toe big. also have numbness cervical neck. I have had a MRI lower back and a MRI contrast . Im numb at back upper neck. They have told me they have found something however im waiting for may10th to discuss with doctor , Could this be MS [/INST] it could be MS. it could also not be MS and be many more diseases like lumbar canal stenosis or some other disease of the peripheral nervous system. what you need is a thorough clinical examination by a neurologist and tests to figure out your diagnosis </s>

<s>[INST] i have had a sore throat for a week, after looking at my tonsils i noticed a round flesh colored lump on my right tonsil. I am curious to know what it is and if it is the reason for why my throat is hurting and why it hurts t swallow and eat. I have googled symptoms and it kept coming up with tonsil stones however the lump does not look like this, it is like a flesh oval on my tonsil. [/INST] Hi,Welcome with your query to HCM Virtual Clinic.Reviewed your query details.You seems to Hypertrophic Tonsil,with fleshy tonsillar swelling in throat.It doesnt seem to be tonsillar stone.Treatment-Antibiotics and Anti-inflammatory with gargles of warm saline,would resolve your issue.This reply would help you to plan treatment with your doctor.Contact after 1 weeks time with a Followup Premium question to ME.Will appreciate your Hitting thanks . Will appreciate review with your excellent review write up comments. Welcome with any other further query in this regard,if need be.Good Day!!Dr.Savaskar,Senior Surgical SpecialistM.S.Genl-CVTS </s>

<s>[INST] Hello doctor, My 48 year old mother is suffering from hypothyroidism from the last three years. The first test for thyroid was TSH, and the result was 15.18. The doctor started Thyroxin tablets of 50 mcg two tablets per day. After that, many times the tests have been done and the dose was increased. Now, she takes five tablets per day. Her recent test results are attached. Please tell me what should we do? What is the dose of Thyroxin tablets according to these reports? Her additional problems include depression, swelling on face, and temperature. [/INST] Hello. I just read your query and went through the reports (attachment removed to protect patient identity). Hope you find my advice beneficial. Good luck. For more information consult an endocrinologist online --> </s>

<s>[INST] Hello. I am 60 yrs young and have had a strange pain under my right clavicle about 2 fingers to the right of the dip, center of neck. It hurts more each day and really bad at night, especially when I go to turn over. It wakes me up. If I try to raise my right shoulder, it also causes that area to hurt. I have researched this and not sure what type of doctor treats clavicles. Can you help? [/INST] Hi,Thanks for your query.From the description, it seems you might be suffering from Costochondritis.The causes are not exactly known for this condition, but certain things trigger costochondritis. It is an inflammation of the cartilage that connects a rib to the breastbone (sternum). Costochondritis usually goes away on its own for some weeks,although in some cases it may last for several months or longer. -Try to rest and avoid activities that make your pain worse.-Take painkillers for the pain (Paracetamol,Ibuprofen etc).Visit the doctor. Your doctor will be better able to diagnose costochondritis. I do hope that you have found something helpful and I will be glad to answer any further query.Take care </s>

<s>[INST] i have a 12 year old son he has behaviour problems and at times like a switch can turn quite violent and angry without provacation have had ongoing problems with my son for 8 years now he attended a behaviour school in chch for a year this helped the family by not being in the firing line but doesnt seem to have had a lot of effect on my son i have been to a lot of medical people to no availhe is disruptive in class pen tapping whistling and generally being a nuisance he is quite intelligent at school he is heading to college next year and wonder how this is going to work [/INST] hi..its difficult to judge what form of disorder your son have..its some form of externalizing disorder, however..like conduct disorder or ADHD..it may also be some emotional problem like deprivation that he may face..so consult a psychiatrist and then get a psychometry done by a clinical psychologist for proper assessment..he wil be fine..wish him good health </s>

<s>[INST] My son fell and stabbed his bottom (on his cheek) on a rusty bolt. He has been restless and irritable all day and now has a fever. I don t have a copy of his shot records and can t get it until tomorrow. I was going to take him to the ER to be sure he didn t have an infection. What do I do? [/INST] well you havent mentioned whether child could walk after the accident. anyway if the child could walk well and active after the accident also it is unlikely to be a fracture. child was irritable and restless may be due to the pain. you have to make sure whether the child is adequately pain relieved. get the wound cleaned well and dressed. since only 24 hours are passed it is unlikely you would get blood counts of infection. so it is better you go to Er with blood reports tomorrow. dont worry even if the fever is due to the wound with good cleaning and antibiotics it would heal in notime. </s>

<s>[INST] i am a garbage man and was poked by a needle through the bag in the leg. i took the needle out and it says insulin on it. i was woundering if i should be real concerned about it? there is just a small red spot under the skin right now. this happened yesterday [/INST] Hi..Welcome to HEALTHCARE MAGIC..I have gone through your query and can understand your concerns..As per your complain a red spot at the site of needle pricking is not an abnormal finding and it occurs due to inflammation caused as a result of soft tissue injury with the needle..In case if the individual who used the needle had some infection or as it was with the garbage the pricking can cause infection in your body too..So I would suggest you to consult an Infectious Medicine Specialist and get evaluated and he can advise you blood investigation to rule out for any infection and can treat you accordingly..An early diagnosis can help in treatment at early stage and you will be saved from symptoms of severity of disease..Hope this information helps..Thanks and regards.Dr. Honey Nandwani Arora. </s>

<s>[INST] Hello, my mother used to drink for 12-14 years then sobered up for about 7. Then she met a man that drank, and for the last 10 years has been drinking as well. She now is sick all the time, with vomiting, hives, loose stools, and has extremly swollen legs and ankels, should I be worried that she is in liver failure? [/INST] Hello,With the kind of symptoms you are telling it is quite sure that she is having increasing liver failure and may be some renal diseases also.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. B.dinesh </s>

<s>[INST] I have a lump about 1 inch below my skull on both sides, and about 2 inches from the spine, it was not there 2-days ago, and has come and gone a few times over the years. Should I be worried, or is this just a passing infection of some gland or the other that the body will fix on its own.? [/INST] HiWelcome to hcmThose are lymph node enlarged some times due to infection or may be nonspecific. No treatment is required unless they are increasing in size or other problem like weight loss , fever, or any abscess formation. You can just observe them at present.Regards </s>

<s>[INST] I've had a bad cold for the past 5 days. Sinuses have been clogged. I had taken some cold medicine for a stuffy nose and that didn't help. Took some mucinex today and that helped unclog the sinus. I find that my chest hurts and have some difficulty breathing. No cough. Couple of people at work have had bronchitis. Do you think I may have bronchitis? [/INST] You should see a doctor. At the very least your doctor will examine you and determine if there are any signs of pneumonia or inflammatory fluid around the lungs. Shortness of breath and chest pain together are concerning symptoms that should be evaluated promptly. </s>

<s>[INST] I had my first colonoscopy in June of 2013 at age 60. The doctor removed 2 polyps - one as a whole at 3mm in size and the other in a piecemeal fashion 8 mm in size. Both of these polyps were located in the cecum. About 8 hours later I developed pain in the lower right abdomen (by my right hip). The pain did not go away and was worse with activity. I called in and they sent me to Urgent Care where the diagnosis was transmural burn sydrome. I was sent home with antibiotics and pain medication and told that if it did not get better to go to ER. It did get better. The lab reported both type of polyps (good and not so good) and I was instructed to return for another colonoscopy in 5 years. Ever since this colonoscopy, I get very brief periods of pain that come on quickly and stop quickly in the same place - lower right. I have had a complete hysterectomy so I know it is not coming from female organs as I do not have any. My question is, do I need to be concerned about the next colonoscopy in 5 years. I get nervous thinking about it as I don't want a repeat of the first one. Thank you for any information you may provide. [/INST] Hi,Thanks for writing in HCM.If the histological disgnosis of the removed polps does not show any evidence of premalignant or malignant changes then you need not worry at all.The symptoms which you developed after the first colonoscopy were due to the procedure itself. As all is fine now there is no need to worry at all..Regards </s>

<s>[INST] hair lossdear dr. my age is 21 height is 5.5 iam male... my hairfall is not stoping since 1yr one of my friend said it is due to less vitamins in body so m taking REVITAL multivitamin capsule daily one after dinr...so it vil b helpful for me or not ?? wat should i eat to gain more vitamins in my body and make my hairs thick enough..please hlp me out... i masterbate my penis alot is it due to it ??? [/INST] Hello,Welcome to healthcare magic.I understand that you are having hair fall for more than a year.The causes of hair fall in your age group could be poor diet, stress, physical illness like fevers and hereditary type of baldness.You could continue taking a vitamin supplement containing 5 mg of biotin everyday. It will help to strengthen your roots.You could consult a dermatologist to assess the type of hair fall. Hereditary type of hair fall can be treated with minoxidil solution and finasteride tablets, both of which are US- FDA approved for hair fall. These have to be prescribed by your doctor.Have a good diet rich in vitamins and anti oxidants like fruits and vegetables.Hope this helps you.Take care. </s>

<s>[INST] I hit my shin really hard on a step while getting into a van about two weeks ago, it hurt a lot at the time but i thought it would be fine later on, never thought to put ice on it or anything. It never looked very bad from the outside, there is light bruising and a bump, however despite its appearance, it is still very painful and very sensitive to touch, the bruise and bump have not seemed to change since the i got the injury, and it doesnt feel like its healing. should i go see a doctor or wait a little longer and see if it goes away? [/INST] Hi,Thanks for your query.From description , this hard lump most probably formed due to haematoma formation (collection of blood) which might get fibrosed or calcified.It will take few weeks to months to get disappear.I suggest you to consult an orthopaedician nearby for a detailed examination of swelling. You may get the X-ray of the area affected under his/her guidance.Meanwhile give hot fomatation over it, You can take Tablet Motrin 1 tablet with food as and when required (upto 4 tablets daily).I do hope that you have found something helpful and I will be glad to answer any further query.Take care </s>

<s>[INST] Hi , This is Naga age 29. I have cold for almost 15 days and my left nostril is continously blocked. I cant breathe easily when i am in A/C. I have a sore throat as well. From childhood , i am immune to cold. I stay away from cool drinks, ice creams as i get effected with cold immediately. [/INST] Hello! you seem to have Allergic rhinitis with respiratory tract (throat) infection . I would suggest you take a short course of Tab. Montek LC,an antibiotic either Tab . Amoxyclav or Tab. Azithromycin , Tab. pantoprazole. Use Budanase AQ nasal spray .Do gargling with betadine gargle solution four times daily and do regular warm saline gargle. Drink only warm fluids. Keep away from cold and dust . Hope this helps. Do drop in your valuable feedback. </s>

<s>[INST] I just noticed a brown spot on the inner part of my 9 year old daughter s ear. It looked like dirt stuck on her skin but I tried to rub it clean and it didn t come off. I gave it a couple of days thinking maybe it was a scab but I still can t remove it. Should I take her to her pediatrician or a dermatologist? It s about 1 cm in diam. [/INST] Hi.... by what you say I feel that this is a fungal infection of the external ear canal.I suggest you take her to a pediatrician.Regards - Dr. Sumanth </s>

<s>[INST] my tsh level is 3.1 in 2009 and was asked to take thyronorm 25mcg for 6 months.after taking medicine for about 1 year my weight increased by 5kgs,side effects like pluffed face,swollen legs and hands ,hair loss was noticed.sir please suggest me to continue thyronorm or stop the medicine. [/INST] HiYour latest thyroid profile values are required to decide the next coourse of action. TSH levels between 0.4 to 5 means that the drug dose is sufficient. Incase of higher values,dose must be increased and incase of lower tsh,the dose must be reduced. Thyroxine does not cause weight gain.Absence of thyroid hormone increases weight gain. Physical activity and healthy diet is also essential.Monitor thyroid levels every 1 to 2 months.Hope I have answered your query. Let me know if I can assist you further. RegardsDr.Saranya Ramadoss, General and Family Physician </s>

<s>[INST] Hi doctor,My wife was suffering from thyroid. TSH value initially (eight weeks pregnant) was 4.98. Now all the tests are good. We are using Thyroxine tablet early in the morning. After 10 days, once again we went for the test. Now TSH value is 4.5. Can you please explain is there any problem occurring to the baby in the womb? [/INST] Hello. Your TSH (thyroid stimulating hormone) is 4.5 which is within range. But in pregnancy, thyroid hormone requirement is increased and so it is advisable to maintain TSH between 2 to 3 in a hypothyroid patient. In pregnancy, TSH monitoring is advisable at one monthly interval. You can increase the dose of thyroid supplement to bring TSH more down. I suggest you consult an endocrinologist for examination and get prescription accordingly. For more information consult a family physician online --> </s>

<s>[INST] I have itchy watery eyes, sneezing, headaches, itchy throat, sometime difficult to breathe and 4 to 6 red spots on hands, arms and legs. I have these symptoms but not everyday, this has been happening for about 10 months now and symptoms are appearing more often and slowly getting worst. Two month ago I went back home because my Father was ill and passed away, I was there for about two months and didn't have a symptom, came back home and everything started again. I believe this is a allergic reaction to something in my home but how do I figure out what it is. Just hoping you have some advice. [/INST] TO PIN OUT ALLERGIES WE HAVE TO GO FOR TESTS OTHERWISE NOT ABLE TO FIND WHAT IS CAUSING IT YOU CAN THINK OF NVIRONMENTAL ALLERGENS AND GET BLOOD TESTED FOR THESE ALLERGENS FOT PREVENTING I CAN GIVE YOU TIP DONT USE MUSTARD COCONUT WALNUT GROUNDNUT ALMONDS SOYABEAN OIL USE OLIVE FOR COOKING AND APPLICATION USE NONTOXIC SOAPS SHAMPOO CREAMS APPLY NEOSPORIN H EYE OINTMENT IN NOSE BD FOR PREVENT SNEESING PUT SEA WATER DROPS 2 DROPS AT NIGHT EACH NOSTRIL CAN LOCALLY APPLU ANTIALLERGIC CREAM FOR SKIN LESIONS TAKE LOT OF WARM WATER CAN TAKE ALLEGRA 120 MG SOS IF SEVERE SYMPTOMPS </s>

<s>[INST] hello,I've had a minor rash on my upper left thigh for three weeks. I have to look close to see it, but a few small red areas can be seen. sometimes it itches, most of the time it doesn't. it has looked the same since i first noticed it. any ideas? thanks [/INST] Hello. Thanks for writing to us at healthcaremagicI will keep a possibility of fungal infection/tines cruris.Involvement of Inner thighs and folds is classical of tines cruris. It may be unilateral or bilateral.Itching is a feature in fungal infections.I would suggest that you may use an OTC topical antifungal e.g clotriamzole 1% cream, twice daily for 2-4 weeksAn OTC oral antihistamine e.g cetrizine 10 mg once daily will provide you symptomatic relief from itching.If the rash does'nt respond as expected Or if it worsens, you may visit a specialist dermatologist for a review.Regards </s>

<s>[INST] Hello doctor,What are my chances of getting pregnant after taking the emergency pill within 24 hours of having sex? [/INST] Hello. Your chances of getting pregnant after taking the morning pill are very low. But it also depends on what day of the cycle you had sex and how long is your cycle and was it the only episode of unprotected sex in this cycle. Your period might get delayed or you might experience spotting with morning pill. </s>

<s>[INST] I have what feels like a fluid filled lump across the front of my knee. It varies in size, from somewhat long but pencil thin - to what looks like a walnut under the skin over my knee. It doesn t hurt, but is larger now than when I first began to notice it. I don t know exactly when I first noticed it but I m sure it has been more than a year. [/INST] Hi.Thanks for your query. The changing size in lump over the knee joint over a year, feels like has a fluid in it can be due to synovial cyst.Synovium is the covering of joint and supplies the lubricating fluid to the joint for unabated friction-less movements. Occasionally a part becomes large or inflamed or has a connecting cyst. Sometimes the pre-patellar bursa can also have similar changed and hence you should consult an Orthopedic Surgeon and get clinical evaluation and MRI of the knee to get the exact diagnosis and a plan for proper management. </s>

<s>[INST] I have swelling and severe pain and burning in my toes (for 18 months). Gout and diabetes have been ruled out. An EMG over a year ago said it was not neuropathy. A friend was told by her oncologist to take B6 to ease neuropathy-like pain during chemo treatment. Is this a possible solution for me? [/INST] Hi there,welcome to HCM.Thank you for your question.Swelling with pain and burning over toes can be most commonly caused by conditions like Diabetes and Gout,which have been ruled out in your situation.Neuropathy is a generic term used for a set of conditions which can result in the symptoms u have.Most commonly such systemic conditions like diabetes or vitamin deficiencies would cause symptoms on both lower limbs.EMG in isolation would be insufficient to rule out all kinds of neuropathy. Additional tests like blood tests for vitamins,nerve conduction studies for nerves would help in ruling them out. If your symptoms are only one sided, regional causes like pressure on nerve at certain points of your limb need to be ruled out.Narrowing of blood vessels in your limbs can also lead to such symptoms. Any injury in the past can also present with pain and swelling now.In addition,there are certain medications which can cause similar symptoms as a side effect.I would suggest you to meet your physician for further evaluation and follow up with a neurologist.Since smoking is associated with and can exacerbate all kinds of neuropathy, you should consider quitting it, if you do smoke.Hope this answers your query Thank you.With best regards. Dr.SBK </s>

<s>[INST] Hello doctor,I am a 27-year-old pregnant lady. I am in 31 st week of pregnancy. My WBC has been increasing off late. My present WBC count is 19.0×10^3 cells per liter. And I have not had any infections from the time I am pregnant. Now I have been asked to get an MPN panel test. It has got me worried. Now I would like to know the chances of MPN test results being normal? And I would also like to know if this happens to pregnant women where in the WBC increases during pregnancy and goes back to normal after delivery? [/INST] Hello, Welcome to the icliniq.com. The total WBC count can be elevated normally as well in pregnancy. It is a physiological response to pregnancy. The count can generally return after some time. If there is no sign of infection like sore throat, cold, burning micturition, diarrhea, etc., then you might not worry regarding that. However, kindly attach your CBC (complete blood count) report so that I can comment further. It is advisable to investigate with peripheral smear examination report first and then if needed MPN panel by flow cytometry suggested. So your chance of having MPN negativity can be predicted after looking your full CBC and peripheral smear examination report only. So kindly attach that two reports. I hope I have answered your question. </s>

<s>[INST] I am taking citalopram and I have a really bad cough because of a cold. My husband bought me Delsuym and I took it as directed without looking at the label. About an hour later I got nauseous and I have vomited twice since. Is that related to a drug interaction or just because of the coughing and cold? [/INST] HiDelysm is a medication used for temporary relief of coughs without phlegm that are caused by certain infections of the air passages (e.g., sinusitis, common cold). Slight drowsiness/dizziness, nausea, or vomiting may occur as a side effect.You can avoid further intake if vomiting continues.Hope that was helpful.Let me know if i can assist you further.RegardsDr.Saranya RamadossGeneral and Family Health Physician </s>

<s>[INST] i got a serious hit in the face and for a few dats i have this lump by my eyes thats hard the eye is not swollen byt the lump has my face looking funny i am suppose to leave the country on friday is there anything i can do to help it go down faster [/INST] Hi ! Good evening. I am Dr Shareef answering your query.With the history of trauma, possibly the lump near your eyes is a hematoma (collection of blood) due to the hit. This might take at least three weeks for it to get absorbed by the tissues. If it does not, then you might have to consult a general surgeon to rule out any chances of a continuing accumulation of blood, or an organised hematoma, which might require some kind of intervention. The hematoma might reduce with aspiration and a pressure bandage for the present, but one can not rule out recurrent accumulation of blood in it. Therefore, it would be better not to do any invasive procedure on it without any definite medical indication. I would rather suggest you to get it clinically examined by a general surgeon in your area for proper management.I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.Thanks for choosing health care magic to clear doubts on your health problems. Wishing you an early recovery. Dr Shareef. </s>

<s>[INST] My son 8 years old has hive like rash on his arms and leg now on torso. I give him benedryl and it goes away and re-appears when the benedryl wears off. He has been allergic to dogs, milk soy and eggs but has not been in contact with any of those. He has no ever but is tired and was tonight a bit dizzy. We just got back from a trip to Barbados ( for a week) could this be not hives could this be a virus? If so what type of virus would cause this rash that looks and is itchy like hives for two days and no fever? [/INST] Hello,Welcome to healthcare magic,From your description and past history it could be hives ( Acute urticaria) and need not be any viral inection. It is characterized by itchy red or skin colored raised wheals which is transient, that means appears in one place and soon disappears from there to appear somewhere else. The most common cause of acute urticaria is food. Seafood, meat, poultry, egg, milk, peanuts, apples, brinjal, strawberry, coloring agents etc are commonly implicated. It is subjective and any food can cause it. Other common causes are medicines, infections, insect bites etc. Antihistamines like benadryl is the medical treatment. Identifying the trigger and avoiding it is the best treatment.Hope this helpedTake care </s>

<s>[INST] Just got my mri back, Never in my life seen about my lower back pain. Results show degenerative disease with discs rubbing together and he said there were spurs pushing on my nerve bundles as well. He suggest a chiropractor and physical therapy. The pain is very severe and I don t have the time nor money for long term therapy. I m 50 years old and just want some relief on a daily basis, nothing too strong but what do you suggest ? Thank you, Pete. [/INST] Dear Sir, spinal extension exercises are permanent solution of your back and spianal strengthening exercises prevent from recurrent back pain, before that go IFT and IPT for reduce your pain and back muscle stiffness. It will not cost too much. Do your exercises regularly. </s>

<s>[INST] My. Dad will be 94 in 2 weeks. He was diagnosed with CHF in July 2012. He is on diuretics n Pradax, K, n BP pill. He has Gilbert's synd. so his bilirubin is always elevated . For past 6 months it hs been elevated . He is jaundiced. This has caused severe itching of body. During the nite he accidentally itched ,, his leg n has reoccuring. Blisters on left leg for 6 months. We have been to primary mid, dermatologist, and now he is getting leg wrapped by PT at a lymphadema clinic. The blisters healed after 3 weeks n we stopped wrapping n in 2 days blisters reoccur n we resume wrapping? We had them cultured 2 days ago as even PT is puzzled? Yes he has edema of both legs from CHF. He is very alert n with it mentally. If you can give any suggestions we would love it! [/INST] Hello! Thank you for asking on HCM! Regarding your concern, I would explain that it is not a rare finding when chronic limbs edema complicates with skin irritation and superimposed infection. Besides the advices given by dermatologist, I would recommend to promptlty treat the predisposing substrate; that is edema (it leads to inadequate blood circulation to the surface tissues, predisposing to more readily skin inflammation).I would recommend to adjust CHF therapy; especially loop diuretics. At least an intravenous root of administration would be preferred, to decrease congestion as soon a possible, and an appropriate oral maintenance dose should follow.A comprehensive clinical evaluation; physical examination, coupled wit hcardiac ultrasound conclusions, liver and renal function tests, blood electrolytes, chest X rays would better guide optimisation of CHF therapy.You need to discuss wit hhis cardiologist to review these data and make the best decision.Hope to have been helpful. Greetings! Dr. Iliri </s>

<s>[INST] My friend keeps having what seems to be panic attacks but it keeps getting longer in time and closer together in days/time as well. She becomes dazed and won t really speak and her eyes will cross and roll to the back of her head and she will cough and convulse and sweat and tense up and so much more, any ideas? [/INST] HiThanks for using healthcare magicThe way, you have explained the symptoms, it is more likely dissociative disorder. It happens due to underline stress or conflict. In her case, you should take help of a psychologist for proper mental evaluation. Treatment includes the resolve of stress or conflict. In case, you need further help, you can ask.Thanks </s>

<s>[INST] Hello. Today my lower gum near my Lower labial freunulum hurts. i have never had this happen before in my life and im a bit worried. I also have a cold . What is this and what can i do [/INST] hi it most probably is apthous ulcer ( oral ulcer ) or traumatic injury. in either case , dont worry. apply MUCOPAIN or DOLOGEL ointment in that area 4-5 times a day and dont eat or drink anything after that for atleast an hour. also drink lot of cold water. it will heal within a week. if it persist longer than that, go for a checkup. wishing you speedy recovery With best regards Dr Ankit Aggarwal </s>

<s>[INST] My friend's dad was diagnosed with stomach cancer last year and he actually had his entire stomach taken out. I read that people with no stomach should take liquid/chewable vitamins, ADEK vitamins & sublingual/injectable B12. Just wanted to make sure these are really recommended for people like him. [/INST] Hi, dearYes its recmmended. Because absorption of many vitamins take place in stomach. so if stomach is surgicaaly removed then deficiency of that vitamins may occur. so it is recommended to take vitamines supplements.Hope i answered your question. If you have any doubts then feel free to ask me. I will be happy to answer you. Thanks for using health care magic.Wish you a very good health. </s>

<s>[INST] when after i masturbate in the room, i wipe sperms with a old cloth.. but problem is not that..... after that i want to clean everything i touched (Like key board, mouse, computer table, door handles, chairs and everything i touched) in my room with Dettol... is it a sick? i spend more than 3 or 4 hours to do this... if i didn't do this i cant live in the room... it's unpleasant.... please help me... [/INST] Hi friend , After reading your complaints the symptoms suggestive of OCD (Obsessive Compulsive Disorder) . After masturbation a thought of unclean touched objects comes repeatedly in mind & you cant resist or stop this unpleasant thought - the symptom is called Obsession. Due to obsession you develop anxiety and to relieve anxiety you clean those touched objects - the symptom is called Compulsion . For firm diagnosis we need detailed history , Mental status examination & investigations. Generally we give SSRI group of tablets and Behavioral therapy to treat OCD . You should consult Psychiatrist soon for firm diagnosis & treatment. Take Care.Regards </s>

<s>[INST] My computer keyboard id acting up a bit, so please bear with the potential typos. etc. I was recently in a bad car accicdent. I felt fine afterwards even though the car wa s totaled . But the next day the main knuckles i.e. closest to my hands hurt so badly I couldn t move them, and below the knuckles down to the base od the thumbs burned like fire. The right hand eventually healed but the left just seems to get worse asnd worse (and I m lrft handed). This is very distressing to me. I ama professional quitarist and have been so for forty plus years. A nurse friend said it might be broken. Any ideas? [/INST] Hi Hope this message finds you in good health.I have gone through your complaints and understand your concern.I generally see many cases like this at my clinic.though it seems very likesly,but still i advice you to get an xray done to find out the cause of pain,even if it is broken proper treatment should heal it up.You should eventually get back to normal in coming few days.Nothing to worry about.     I hope your question has been answered.If you have any follow-up queries,feel free to consult me anytime.Thanks,Take care,God bless. </s>

<s>[INST] I am blessed with twins, they are 3.5 months old, both are having problem in paasing stool. They pass stool once in 2-3 days only when the medicine is given to them and whenever they pass stool, they cry a lot and feel a lot of pain in stomach. Please tell me what to do to avoid constipation ? [/INST] Hi I'm Dr Suresh K Yadav MD(paediatrics) , I have gone through your question and understand your concerns,Passing stool every 2-3 days can be normal in this age provided stools are not hard. Thyroid function tests may also be done to rule out hypothyroidism . Drops like figolax can be added after discussing with your health care provider .Hope this answers your query. If any more question or follow up query do right to us. I will be happy to answer your question.Take care.Thanks </s>

<s>[INST] My son had a lesion on his scalp biopsied because it was irregular in shape and color, and had grown rapidly to about 6/8" across. The results came by "atypical melanocytic proliferation of uncertain malignant potential" and the pathologist recommended wide-excision of the remainder of the lesion. The dermatologist wants to be more conservative and monitor it every 6 months for changes. My son is 22 years old, has had transient increases in his liver enzymes lately, has had some weight loss (about 15 lbs - he is 6'3" and weighs 167 lbs), and has 2 enlarged lymph nodes in his neck. I'm scared and feel a conservative approach is not the right route at this time. Am I being too paranoid?? Thanks. [/INST] HiWelcome to Health care Magic.The swollen lymph nodes in the neck are secondary to melanoma. This requires evaluation to rule out spread to the lymph nodes.Hence I advice you to consult a surgeon for a second opinion.Hope this is helpful to you.Please do write back to me for further questions.Thank you </s>

<s>[INST] I ve had this pain in my back on the left side near the bottom of my rib cage. I started out, I thought , as a pulled muscle from work lifting heavy boxes while I was straddling some bins on 2 x 4 s up about 8 ft high while some one lifted them up to me. This was 5-6 days ago. after 3 days it seemed to get better however my friend rubbed it for me 2 nights ago very aggressively ( hurt like hell but I thought it would help ) and the next day it seemed a little better. However, today there is a defined lump that hurts alot when pressed but the lump is a bit farther away from the original pain site which was closer to the spine ( paraspinal muscles ). The lump is approx. 1 1/2 in diameter and raised just a little bit. Help, what might it be? Brenda [/INST] Magnetic therapy-;--- youmay put a strong south pole magnet on left back ,paining place and med.north pole in between heap and knee,again strong south pole in between knee and toe forabout half an hour twice in a day for five days and report. </s>

<s>[INST] I have been having this odd fluid like feeling in my lower abdomen and around my appendix, I went to the ER, they did a CT scan , X-Ray , Ultrasound and blood work. They claimed I was fine, but my appendix looked odd. They claimed it was like that from birth and that I was just overly constipated. I have had bowel movements since I ve been in there and they told me to take Laxitives, the first one was close to pure liquid. I have no more pain, but I still have a fluid-like feeling and tinglyness around my bellybutton and appendix. What could it be? What should I do? [/INST] Hello,When the radiological and blood test are normal then this may be due to constipation and gas collection.Absence of pain again indicates that there may be no pathology. </s>

<s>[INST] Dear Doctor, 3 Months back i came to know that my sperms are less,at that time it was 10 million per ml and 10% of them alive rest sluggish or dead,after one month of tratment ,the report says 15 million with 15% alive ,after another one month it was 22 million with 15% alive ,after another month it was 28 million with 60% alive , but i stooped taking medicine for 15 days and than the report says that it was 22 million with 10% alive,so ,plz tell me what should i do know [/INST] Hi, Do you have varicocele? Have you tested for anti-sperm antibody and hormonal imbalances? Take these tests and report for consultation. Do yoga and physical exercise for better results. I hope I have answered your query. If you have further doubts, I would be happy to help you. Happy day. Regards, Dr. S. R. Raveendran, Sexologist </s>

<s>[INST] sir i m AAAA .my semen report is not normal.colour -dirty white, volume-4ml, ph-8, total sperm count-5million/ml, active-5 % ,sluggish-30% ,dead-65%, normal-80%, abnormal-15%, head defect-3%, tail defect-2% , pus cells 3....5 , remarks=oligozoospermia with u.g.t infection.how i can increase my active sperms n what medicine i should use so i can get pregnent to my wife. [/INST] Hi, Welcome to Healthcare Magic. Lifestyle changes is the first step in improving the quality and quantity of spem. Stress relief, avoiding smoking and alcohol, avoiding tight fitting underwear, weight reduction if obese would all would improve sperm count. Treat the infection you have. If all these measures fail, then surgical conditions like varicocele should be ruled out with a doppler scan of the scrotum. If there is no varicocele, then you can try taking supplements like L carnitine to improve the count and motility of sperm. Hope that answers your question. </s>

<s>[INST] Just checking on the drugs a young lady swallowed in suicide attempt - Slow K, frusemide, Duloxetine , Prednisone , Mirtazepine, Propanolol. It would appear she got a hold of family members prescription meds and swallowed a bundle. She is now home from hospital in the care of her family. Strong Family history of suicide andPrevious impulsive overdoses. Just looking at what we can do at work to support this young woman if she allows us to do that. Cheers Patricia Simpson, Boeing Aerostructures Australia at Bankstown NSW [/INST] hi..this is challenging..probably she is suffering from personality disorder..also may be recurrent depressive disorder..get help from a psychiatrist for medication which should be kept out of her reach..close observation is needed..also proper counseling is required by a clinical psychologist to remediate her impulsivity..she is in particular risk because of her family history..so the sooner, the better..wish her good health </s>

<s>[INST] hello Doctor,My name is anshul, male, age 23. I live in delhi. i am very much troubled because of my allergy. in this, firstly my throat starts itching, then 8-10 continuous sneeze and then runny nose and sometimes itchy too. I took homeopathy treatment also but it doesn't helped me much. Usually it occurs in the morning time as i woke up and comes out of my room. And sometimes when there is regular 2-3 times in and out of AC room. Even when i leave my house for office, do a 7 mins walk and then board the metro(means from sweating weather to AC metro) this allergy starts. I am very much troubles because of this prob and now am scared if this prob may harms me in future. Kindly suggest me some treatment or anything which can help me out for this allergy.Anshul Garg0000 [/INST] Hi and thanks for the query,A complete clinical review is required to better manage this allergy. First, the nostrils need to be evaluated for any possible polyps that could predispose to allergies.Secondly, it is necessary to measure serum or blood Immunoglobulin E, IgE, this is the main marker of the intensity of the allergic response in the body. based on these findings, treatment could then be started. Avoiding a possible substance or trigger to the allergy is a key component in the management. drugs could be prescribed ranging from steroids oral to injectables, anti histamines, through injections or sprays. You might to consult your internist first. In case the allergist if needed, you shall then consult him.Thanks and kind regards, Bain LE, MD </s>

<s>[INST] due to frequent masturbation for 5 to 6 years my penni becomes so weak and small sometimes there is a erection but for few seconds and after that it again come to his original soft and short position i am also sufering with weak erection and i cant see a naked photo for mor then one min after then the white water comes out of my penni without any disturbance [/INST] Hi, It can be due to stress, diabetes and hormonal imbalance. You can take antioxidants and zinc supplement basically. With that regular exercise and yoga can help you.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. S. R. Raveendran, Sexologist </s>

<s>[INST] Hi i am 42 years,174 cm,62 kg, married man.I have no medical history.my sex life also is satisfactory.Since past few month i am having premature ejaculation.during foreplay/ just before starting sex i ejaculate.Please suggest or prescribe any madicene. [/INST] hii.welcome to our site.i understand your problem.my opinion is that,1.do masturbation 1 hour before having sex.it may reduce the premature ejaculation incidence.2.take deep inspiration and expiration while having sex.3.you may use distraction techniques i.e,talking about something other than sex while having intercourse.4.do foreplay for longer time.5.you may use lignocaine spray on the penis 15 minutes before having sex.but dont spray on the glans penis.thank you.hope my answer would have helped you. </s>

<s>[INST] My muscles, skin, flesh have biting feelings sometimes and it goes so deep into my body, especially my hips and the abdominal area. It is painful. Also it feels so good to press the area, massage or rub it, but it is not a good idea because then the pain and discomfort is worse for a day or two. The itching feeling is also in the shoulder joints, elbows--around all bone areas. There is not a part of my body from my neck to the knees that is not affected. There is a rash and my skin has the pain from little needles and also if I stretch to reach something or lay down in bed it is painful until I get settled, then it is relieved somewhat. This has been going on since last May (2010), and has gotten worse now and unbearable. I cannot live like this. I have observed parasites in the stool during this time and have taken a parasite cleanse. My doctor has taken blood tests and stool tests and finds everything to be normal. There is nothing wrong. I have to find a doctor. I have to have some help. Thank you. [/INST] Thanks for your question. i am Dr Asanghanwa Carlson. Going through your query I would say there is a lot of information which if you could provide will help us know what your problem is exactly this includes the type of parasites you see in your stool are they worms or what are they? What provokes the itches all over your body? is it some food, a clothing type, cold, bathing with hot water or some new skin lotion. I will advise you see dermatologist for proper checkup who will examine the type of rashes on your body and request for appropriate tests and prescribe adequate medications. This could be a parasitic infection like filariasis as well as an allergy of some kind or some other skin problem. Good luck. </s>

<s>[INST] Hello doctor, I am 42 years old female going through dry eyes for the past 45 days. I have been to three different doctors but no relief. I feel heaviness in the eyes along with pain and redness. I have been given a gel and a tube (Systane eye drop and Ara gel). Please help. [/INST] Hi. Dry eye syndrome is a condition which can best be managed but cannot be treated, since it is caused by multiple factors like age, environment, etc. The good thing is that it is not dangerous. You are already using Systane (Propylene glycol) and Ara gel (Hydroxypropyl methylcellulose). If no relief from these then you can try more viscous lubricants which stay longer in the eye or you can go for plugging your drainage ducts. Also get your eye sight and eye pressure tested. For more information consult an eye care ophthalmologist online --> </s>

<s>[INST] I fell off a step and my foot went off. I felt a crack across the right hand side of the foot but could walk ok, albeit with a limp. However, my ankle was also painful. That was a week go and the foot and ankle still hurt and there is still swelling lengthways on the foot. It is making my whole leg ache as well as my other leg as I put more pressure on that one. [/INST] Hello, It looks from your details that there can be a a fracture at your foot bone.You should do following to have relief- -Get a x ray of your foot done. -Consult to your doctor. -Take a mild analgesic like advil for relief. -Meanwhile you may apply a compression bandage from below upwards from foot to leg. -Do warm fomentation to have relief from pain. -Keep your foot elevated on pillow in rest. -Do rest. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Mukesh Tiwari </s>

<s>[INST] I have a very odd bump beside my knee...it's on the inside. The skin on the outside is a little saggier than on my right knee. When I press down hard, there is a bump and it feels a lot different than my right knee. Also, my knee has been hurting going up stairs, or standing at times. it cracks sometimes when I extend it. [/INST] Hello! Welcome to HCM.This is more likely a William Morrant Baker's cyst.Its a benign swelling in a synovial bursa.Local examination is necessary for diagnosis.In my clinic, I advise excision biopsy for symptomatic cysts.Excision biopsy means the lump is excised & sample is sent for histopathologcal examination.Hope this helps.Wish you a good health.Thanks.Regards. </s>

<s>[INST] I caught a cold a couple days ago & was sniffling alot yesterday. I ve obviously been sneezing periodically, but a few time when i did I got this burning/ tingling pain/sensation in my lower back & in my pectoral muscles. the pain isn t unbearable, but I worry about everything & I m probably a borderline hypochondriac, soit has me curious & little worried. I vagely remember this happening before when sneezing sometimes. Any answers? [/INST] You are probably worrying about nothing,yes you may be hypochondriac.But sometimes rarely your lower back intervertebral discs may have prolapsed a bit due to severe bouts of sneezing..causing mild compression of the nerve roots coming out by the discs,cuasing the tingling pain.You wil need to confirm this with a Spine /ortho surgeon. </s>

<s>[INST] i have cold and my doc. prescribed me azax 500 .although it helped me a lot but after taking the pill my body starts shaking from inside but not shivering and also i have a loose motion kind of experience after 4 hours of taking the pill.my Q. is is that normal and if not then what to do ? [/INST] Hi. I've gone through your query. I can understand your anxiety. Symptoms you experiencing might be due to azithromycin tablets you are taking. Usual side effects includes diarrhea, skin allergy, fever, Abdominal or stomach pain, drowsiness, dizziness etc. I advice you to, - Consult your doctor if there is severe diarrhea or any kind of skin allergies. - Avoid exposure to sunlight - Take tab. rantac along with it - Avoid taking antacids along with azithromycin ( 2hrs before or after the tablet). Hope I have answered your query. Let me know if I can assist you further. Get well soon. Regards, Dr. Yogapriya V, General and family physician. </s>

<s>[INST] I had a colondoscopy done yesterday....a couple spots were noted as having cystic lesions {50 cm}....normally a biopsy/sample would have been taken except I am normally on blood thinners. {aortic titanium valve implant} so there would have been the risk of bleeding. So now I am scheduled for a cat scan this week......what are they looking for...what will scan show .....if anything ....is there a cancer concern? If this is cacerous...what is next possible step procedures....58 year old male....very good health...Thankyou! [/INST] Hello.The cystic lesions are benign and only become malignant exceptionally. why do you a tc-scan is because you are taking anticoagulants and biopsy is not possible.If tc-scan is normal are not necessary more additional tests. I wish you good health.(If the answer has helped you, please indicate this) </s>

<s>[INST] hi I am a 30yr old female and diagnosed for lumbar spine L5 S1 slip disc problem with the spine slightly pushing further. Also I was been treated for sciatica. I have recovered 90 % but still there is a lock on my lower back bcoz of it pains from the right side of my lower back or hip and also the same pain passes through the back of my right thy and caughfs. Please suggest me how do i get rid of this pain. I dont want to have pain killers just for the sake of having it. [/INST] Hello, Since you are feeling better, and you don't want to use painkillers, physical therapy may help you. In particular, lumbosacral traction may be more effective.Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Erion Spaho, Neurologist, Surgical </s>

<s>[INST] I had a rash, it appeared on my bottom, spread down my legs and then appeared on my underarms and elbows. I was prescribed triamcinolone acetonide and after a week, the rash went away, but I was still itchy. Now, two weeks later, the rash has come back on my arms. The doctor didn t know what it was and just prescribed a topical steroid, telling me that I might need to go to a dermatologist. But, I don t have health insurance and can t afford it for at least 3-4 weeks. I don t think I can wait that long! It itches very badly. It s not scaly and it s not raised either. What can I do? What could it be? [/INST] Hi, Most possible diagnosis could be tinea infection. But there are many other possible diagnosis. You could take an over the counter antihistamine tablet for itching. I request you to stop all the medications and to visit a dermatologist. He will examine you skin and confirm the diagnosis and will initiate the treatment. Hope I have answered your query. Let me know if I can assist you further. </s>

<s>[INST] I was prescribed anti-fungus cream (Mystatin and Triamcinolone Acetonide ) for an apparent fungus infection by my doctor last week. The condition improved significantly or went away. However, I just noticed a rash around the near side of the area with small red spots. I have exposed and aired the area and it seems like it helped. The secretion seems to be gone and the redness diminished. Thank you for the advise provided. Sincerely, [/INST] Hi,From the description it seems, you might have developed intertrigo. Intertrigo is characterised by itchy burning red macerated rash. It can occur in obese people or during humid climate when underclothes are too tight to cause friction in sweat prone areas like axilla, groins, inner side of thighs or infra mammary area.To treat the sameKeep the area dry and well ventilated. You may also dust the area with antifungal powder to prevent it from occuringWear loose cotton underclothesUse a mild steroid antifungal cream to treat the rashHope that solves your query. Take care. </s>

<s>[INST] I am 66 yrs old, with back pain . I just had two knee replacements and I had the back pain prior to the surgeries onmy knees. I had an MRI done and saw a back surgeon today. He told me I had a small amount of spinal stenosis, but the lab results also show a 9 mm cyst on my kidney. He is sending me to a urologist for further examination. I have been a smoker for many years and have stopped in March of this year. The pain in my back has been there for a while and the pain goes doewn to the crack of my butt . I have to wear a depend because I can't get to the potty fast enough when I need to urinate. I'm scared and I'm making an appointment to see a urologist. Should I prepare myself for cancer? [/INST] Hello and welcome to HCM,A cyst in the kidney is not necessarily due to a cancer.Smoking is a risk factor for developing cancer however, presence of cancer is not confirmed by presence of a risk factor.Cysts of the kidney are usually benign.Symptomatic cysts are surgically removed and examined histopathologically to look for any evidence of cancer.If it turns out to be benign, no further treatment is required.If it turns out to be malignant, additional chemotherapy may be required.So, consult your urologist and don't worry. The possibility of cancer is low but if present, good treatment modalities are available for its cure.The back pain that you are experiencing is due to the stenosis.You need to consult your neurologist for management of spinal stenosis.Thanks and take careDr Shailja P Wahal </s>

<s>[INST] My husband had backpain ,, when we did a MRI they suspected it to be Spinal infection due to TB and then we did some blood test and identified his platelets count low less then 1000 ,, so he was given heavy dose steriod and his platelets not coming up much ,, and then treated with IVIG again it seems didnt worked ,, in between they did his bone marrow examination and they told production is fine and found it as ITP,, now he is under Revolade tablets ,, and they did a biopsy and confirmed the spinal infection is for TB,,now his steriod intake is reduced from slowly and gradually from 60 mg to 10 mg now and also he is taking ATT medicine now for tuberclosis,,please guide us with whether it can be a TB induced ITP [/INST] Hi, It can be TB associated. ITP. This is rare and few cases are reported in international literature. This responds to anti tuberculous treatment. Go By your doctor's advice! </s>

<s>[INST] Hi I am from Asia, male and of age 34. My wt is 68kg and ht is 1.65m, with no known health problems.My issue is my allergy reaction after drinking alcohol. I have rashes on my back, the rear of my arms, my torso and back of my neck. These rashes are small little red dots, and they are really painful when I sweat. Typically takes about a week before I get well. I came across articles on miliaria and after seeing pictures and reading of symptoms, sounds exactly like what I have! So question is if miliaria can indeed by triggered by consuming alcohol? And if indeed so, can I conclude I am actually not allergic to alcohol, but merely that my skin was unable to handle the heat involved with drinking, or that my pores are clogged? I'd like to know that these rashes are limited to my skin and not a symptom of some bigger problems internal to the body. Lastly, please do advice if there is something I can do to prevent these rashes.. They are rally painful (like needles poking) when I sweat, which is really often here in hot and humid Singapore.Thanks for all your kind advice.Alex [/INST] Hi,This reactions is known as alcohol flush reaction.When we consume alcohol, it gets metabolised in body by liver enzymes into acetaldehyde and then into acetate.Alcohol causes vasodilatation of small blood vessels and capillaries and some times bursts this capillaries under skin leaving behind broken capillaries and red spots.Also,alcohol causes diuresis by suppressing vasopressin release from kidney leading to extra work to the kidney and by this water comes out in bladder leading to depletion of water in body leaves skin dry,rough and itchy.This all is direct effect of alcohol in body when consumed in excess,you can consider it as a allergy.The best way to cure allergy is avoidance of contact with allergen rather than taking antiallergic drugs like steroids or antihistamines.Some people(commonly Chinese,Japanese)have inability to convert this excess acetaldehtde into acetate leading to accumulation of this acetaldehyde into blood causing blood vessels to dilate more.And because of this,our skin turns red and slightly burning to touch till this substance clears from the blood by kidney.Best treatment is to curtail this alcohol consumptions.Thanks. </s>

<s>[INST] Hi,my son is 2yr old. he has got cold n cough initially and now fever is rising to 102.doctor suggested meftal p if high fever ,but we observe that fever is coming down to 101 only and cough is also creating problem. he is having restless sleep and temperature is around 101.do i need to do anything else? [/INST] Thanks for the query.You should give him syp. sinarest, and syp. kofarest for cough and cold.Warm steam inhalation may relieve the congestion.Antibiotics may be given if there is infection after consulting a doctor.Hope i helped you. </s>

<s>[INST] posterior and left paracentral herniation of L5-S1 inter-vertebral disc causing compression over dural theca and exiting nerve roots.posterior diffuse herniation of L4-L5 inter vertebral disc causing mild compression over ventral aspect of lumbar dural theca and exiting nerve roots.Right foraminal bulging of L3-L4 inter-vertebral disc causing mild compression over right exiting nerve roots.Annular tear is seen at L3-L4 & L5-S1 levels [/INST] Thanks for your question dear all you have problem with your spinal cord that is buldgig if intervertibral disc from it's normal position taking place from l4 to S1 and there is a tear of anular ligament what you should do make an consultation t neurosurgeon and avoid excess weight lifting </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] my son is downsyndrome ,24years old.He has seizures and tics,.He is on keppra,25ml at night,and topama 100ml,2 of them and 2 25ml at night, and one metoprolol ,25ml,in the mornings,for thyroid .The DR. wants to keep him out of School for 3 months,but I dont see that being so.To me thats like making him being away from the things he loves.Plus I am on staff at Funerals homes as a soloist here in my city,and Singing is my Life, for over 60,years.Since the thyroid iodine treatment Josiah, has had 19,tics and 5 seizures,.However I did send him to Drew Transition Center today,but Friday the DR. faxed info to School about him staying away for fear of hurting himself. Please give me in your opinion [/INST] Hi, Thank you for posting your query. Tics would not hurt the child. However, if the child has seizures, he may fall and get injured. So, if he is able to get someone to look after him round the clock at school, you may send him to school. However, if a full time caregiver is not available or if it is not possible, then it may be preferable to not send him to school. The decision to start sending him to school would depend on the adequate control of seizures. Best wishes, Dr Sudhir Kumar MD DM (Neurology) Senior Consultant Neurologist </s>

<s>[INST] I have been told I have COPD. I have been having problems for 2 months. I am now having trouble coughing until I throw up, I am on Advair , Albuterol, Sinus medicine, and Muscus relief. Is there anything that will stop this coughing. My broncial tubes are very sore. [/INST] Thanks for your question on HCM. I can understand your situation and problem. But COPD ( Chronic Obstructive Pulmonary Disease ) is a disease in which due to airway inflammation, sputum production is continuous. If infection is there then sputum production is more. So antibiotic may be needed in your case.I also advise you to enroll in pulmonary rehabilitation center where Chest physiotherapy and deep breathing exercise Are done. This will help you in clearing your secretions easily. You can also try mucolytic and expectorant like N acetyl cystine (NAC), Ambroxol and guifenacine.Zince all these are prescribed drugs, you should consult pulmonologist and discuss all these. </s>

<s>[INST] i never understand difference between heart attack, conjustive cardiac failure and myocardial infarction.i always become confused while understanding all these terminologies. i am a medical student but never understnd it .please answer my question.i shall be very greatful [/INST] hello. I have gone through your query.Thanks for using HCM. basically heart attack and Myocardial infarction are synonymus .It is a condition where there is total blockage of one of the three coroniaries supplying blood to heart.There is total cut off of blood supply to particular segment of myocardium which results into necrosis that is death of tissue. Congestive cardiac failure is term to denote failing function of ventricles. mainly when right ventricle fails and it produces odema,ascites,neck vein engorgement and hepatomagaly.This is known as CCF. My best wishes Dr.Rajesh teli,MD. </s>

<s>[INST] Hi doctor, My wife is pregnant for the first time and it is her 12th week. We did a blood grouping and urine culture testing last week. It is found that the blood group is 'O' but the Rh was given as 'weak D positive'. We did a second opinion testing in a different lab and the result was the same. Doctors are confused and they say that we need to check what is the blood group of the baby. We are a little bit worried and following are our queries. What type of blood group does she belong to (O+ or O-)? Does that affect my wife and baby for the first pregnancy? Do we need to take any preventive measures to make sure everything is normal or post pregnancy? Please help us. [/INST] Hello. Weak D in itself is a specific category of blood group. Weak D expression primarily results from single point mutations in RhD which encode amino acid changes predicted to be intracellular or in the transmembrane regions of RhD. Molecular RhD blood group typing is very efficient for managing donors and patients carrying any of the various molecular types of weak D and partial D. Weak D people belonging to weak type 1, 2, 3, 4.0, 4.1, and 5 can be treated as Rh-positive and be transfused by Rh-positive red blood cells, while subjects with weak type 4.2–11 and 15 should be treated as Rh-negative and transfused with Rh-negative red blood cells. Ideally, it is important to know the status of the blood group of the mother if she is Rh negative so that anti D injections can be given to prevent complications in subsequent pregnancies if the baby is Rh positive. A weak D positive is generally considered as Rh positive and usually, the anti D injections are not required in such patients. It should not affect either your wife or baby during her first pregnancy and subsequent pregnancies as well. Thank you. For more information consult a hematologist online --> </s>