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ChatDoctor-10k

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If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: hi,i have been sick with cough w excess,mucus,a rash developed on chest ,and back,i also haveon elbow s. I also have red swollen fingernail beds.On my pointer and index finger i got rash and just above top crease there is a small dot that I can pick w a tweezer,have gone for 3 cat scans going back to doc on Tuesday,says its not lupus.connective tissue disease.its really getting old,starting to get fatigue .lost bout 10 pnds.Doc is ok,but its like a month between visits any ideas I can ask him bout.i have taken 2 rounds of antibiocs, been on inhaler,just got off predisone,cough is back up but it productive,but im slow moving.been going on 5 months,since December.any insight would be great 53yr old female lori ### output:	Thanks for your question on Chat Doctor. I can understand your concern. If connective disease is ruled out and since your CT chest are normal as told by you, no need to worry about lung infection. Possibility of bronchitis is more in your case. So better to consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test) with lung volumes and DCO. PFT is needed for the diagnosis of bronchitis. It will also tell you about severity of the disease and treatment of bronchitis is based on severity only. Now since rashes are not your problem and cough I'd only issue now it should felt with. Don't worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks.
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I have severe pain in my lower back, right side, and right buttock that radiates down my leg all the way to my foot. I am often unable to walk without limping. Also both hips hurt and are tender to the touch on the outside of my buttock (bursitis?). I have severe all over pain and stiffness every morning and after sitting for any length of time (ex. eating lunch) and struggle with painful knees, ankles, wrists, hands and feet. All of my blood work, every test you can imagine, has been normal. I have normal e-rays of hips and a normal MRI of my lumbar spine. I take Lyrica and Cymbalta, but still experience extreme pain. NSAIDS do not help. Suggestions? ### output:	Welcome to Chat Doctor I have gone through your query and understand your concern. You are suffering from chronic backache. This may be related to muscles and bone weakness. There may be deficiency of vitamins and trace elements. You can take supplements of vitamins and trace elements. Back exercises are helpful in muscle strengthening. Analgesic such as ibuprofen is helpful in pain relief. If not relieved by it, you can take strong analgesic such as tramadol. You can get vitamin D and vitaminB12 levels and if found low you can take its supplements (vitaminD3 and mecobalamin). You can continue with Lyrics and Cymbal ta, You can discuss with your treating Doctor about it. Hope I have answered your query. If you have any further questions then don't hesitate to writing to us. I will be happy to help you. Wishing you good health. Take care.
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I have had been coughing several times a day for two weeks. Ten days ago I vomitted every two hours for 10 hours and had diarrhea. I felt very weak for three days and then I flew to Hawaii. While there, I was coughing the same amount. My voice is very hoarse but I don t have any pain in my throat. It is just raw from coughing so much. Three days ago, I had intense and uncontrollable chills for three hours, which then turned I to a fever. I took Ibuprofen and it helped. Yesterday when I was flying back from Hawaii, I felt nauseous for the whole flight and then vomitted after we landed. Today I have eaten a little. Ore than I have been. I don t have chills and I don t feel nauseous. I am continuously coughing still. ### output:	Thanks for your query at Chat Doctor! I am Infectious Disease Specialist! I went through your query! You need to take few tests to establish the cause of fever. It could be acute bacterial infection or tubercular in nature. Get your throat assessed first by ENT specialist it could just be allergy. Coughing is causing vomiting. Diarrhea could be due to infection. Take a course of antibiotic to see if symptoms resolve.If it does not improve get X-ray and sputum culture/sensitivity for bacterial/tubercular infection. You might require CENT scan test to see for lymph nodes. Happy to take more queries! You can also write a review for me. If you would like some more information, I will be happy to provide. You can take a follow-up query. Take care!
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: hi i m 30 yrs old female i m suffering from tb. my symptoms is feverish. i already taken 6 mounth madicine AKT-4 kit. then i leave after blood test. but after 1 or 2 mounths i do mantoux test it is positive what i do? i have no kids, i have problem in consive. on feb 2007 i got marriage. plz help me . ### output:	Hello were (are) a tubercular patient and took treatment for 6 months. Months test is still positive even after 2 months treatment stopped. Now for confirmation of tuberculosis get in these tests.==Sputum examination for A F B, if no sputum then get it through nasogastric tube.==Bronchoscopy, because you stopped the treatment, so this is important because Months is still positive.==Chest X RAY, particularly see healed calcified & fibrosis. Also confirm whether FRESH lesions present or not present.==Sputum for TB CULTURE and sensitivity test.==Blood test for C B C (leukocytosis in mild to moderate cases of T B) E S R (if > 100 mm highly suggestive that still T B is active).==Protein Purified Derivative (PPD0-Tuberculin Skin Test. The main question is about the lesion of tuberculosis. As far as about pregnancy, even after 7 years of married life, consult an INFERTILITY specialist and get his opinion. But I recommend you consult a CHEST & TUBERCULOSIS specialist and get his treatment. Hope you will understand seriousness about T B treatment.
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I recently had a micro urine test completed and it said i had urobiligin result of 4, leukocyte +1, trace of protein, and squamous epithelial 67 with a result of "rare". I also had a result of 9 on a vitamin D blood test. My liver test results also say I had a 4 for my bilirubin. Should i be worried? Im 29 yr old female. 167 lbs. ### output:	Hello and welcome to Chat Doctor. Thank you for your query. Yes, there are a couple of things you should be worried about here. Let us first shed some light on the urobilinogen. The causes for elevated levels of urobilinogen (bilirubin in the urine)are:-Liver diseases-Bile duct obstruction-HepatitisAs you have also an elevated serum bilirubin of 4 (whether total or direct), this indicates some abnormality with the liver. Please conduct an ultrasound of the abdomen and pelvis and also check other parameters in your liver function test. Also, it is important to note that your vitamin D levels are very low. The normal levels are 20-56 NG/ml or 50-140 MOL/L. Levels below 32 NG/ml are considered to be low, and a level below 20 NG/ml can cause serious conditions and predispose to conditions like breast cancer. Please meet your doctor at the earliest and initiate vitamin D injections at the earliest. I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications. I would gladly help you. Best wishes.
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: hi doctor my grantmother is suffering from juindce.doctor advised for lft .reports are given below bilirubin 8.69mg/dl, aspartate amino ast/ sgot 138mg/dl, alanine aminotranferese 68u/l alkaline phosphatase 1857u/l total protiens 8.20g/dl , albumin alb 4.00g/dl. is my grandmother ok or having chronic lft dieases. tell me solution .plz thanks ### output:	Hello, Thanks for using Chat Doctor platform for medical advice. According to blood reports, it seems that your grandmother is suffering from obstructive jaundice. Normally liver from the bile (juice for food digestion), it flows via tube (bile duct) to intestine and there it's mixed with food and help in digestion of food. In obstructive jaundice, there may be blockage anywhere from liver to intestine in bile duct (bile flow tube). Ultrasonography is helpful to know about obstructive jaundice, and it also tells about cause of obstruction. Consult your gastroenterologist for further investigation to know more about the disease and treatment. Depending upon underlying cause, it can be treated with either Endoscopy or Surgery or by both. If this remains untreated, then it may progress to complications like high grade fever, liver damage, yellow coloration of whole body, severe itching, loss of desire to eat...Meanwhile, ask her to take plenty of water and high carboy Chat Doctor. I wish for speedy recovery of your grandmother.
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Dry socket after absessed lower molar, rt.side. Pain is a 10.Dentist put a clove paste packing. Had it done twice. Pain subsiding (now an 8) How long is this going to continue. Am 5 days post-op. Pain, pain go away. Probably should have had an oral surgeon instead of my general dentist extract. Had to have tooth removed in 3 pieces. Need more. How do I tell my dentist I want next done by oeal surgeon without him possibly flipping out? Off my anti-coag for 7 days prior to surgery. Please help! ### output:	Hello, Thanks for your query. Take painkillers as prescribed. Apply an ice bag to the affected area immediately after the procedure to keep down swelling. Apply ice for 10 minutes at a time. Relax for at least 24 hours after the extraction. Limit activity for the next day or two. Avoid rinsing or spitting forcefully for 24 hours after the extraction to avoid dislodging the clot that forms in the socket. After 24 hours, rinse with your mouth with a solution made of 1/2 teaspoon salt and 8 ounces of warm water. Do not Chat Doctor. Do not smoke, which can inhibit healing. Eat soft foods, such as soup, pudding, yogurt, or applesauce the day after the extractionContinue to brush and floss your teeth, and brush your tongue, but be sure to avoid the extraction site. I do hope that you have found something helpful, and I will be glad to answer any further query. Take care
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: My name is Curtis and I was diagnosed with diverticulitis in 2008. I had to have 8 inches of my colon removed 10 days age. The surgeon removed the bad section of colon, put it back together and stapled my abdomen back up...the incision appears to be healing well. The problem is that while my surgery was 10 days ago...I still cannot stand to eat food. All foods taste horrible to me and sometimes getting a small amount of food and just looking at it makes me a little sick. Things like bread and such are the worst, it tastes awful when I eat it. It seems the sweeter something is though, the easier it is for me to choke it down real fast so that I dont die of starvation. How long should food taste so awful and when should I be back to eating normally again? ### output:	Hi Curtis welcome to Chat Doctor forum. Thanks for asking a question to Chat Doctor. Forum. You got 8 inches of the colon removed 10 days ago. Healing is fine, you have got change in taste, and anorexia. As it is the 10th day of post operated period, it will take time for the G, I.system to get accommodated, and get digestion takes place normally. During this period there will be some stagnation of the remaining colon and some adhesions around the sutures will be there. Once all these are adjusted you will have a normal appetite, and taste. I advise you to consult you doctor for menu and diet program. I also advise you to take more of water and liquids and semi solids as for as possible. Wishing for a quick and complete recovery. Best regards.
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: My son is 21 years old and autistic. He has been taking prozac for 4 months. He has been suffering from a cough for approximately 3 weeks. The Dr. perscribed anti-biotics for 10 days and said if they did not solve the cough he has allergies. He finished his course of anit-biotics and then the symptoms got worse. He has nearly passed out from wheezing and shortness of breath. He says he cannot get the air out of his lungs. He has wet coughs with clear or pink sputum. The episodes last for approximately 10 minutes once per every 1-2 days for the last week. They have occured twice while sleeping and 3 times while active, both in doors and out dooors. ### output:	Thanks for your question on Chat Doctor. I can understand your concern. By your history and description, possibility of bronchitis is more in your sons case. So better to consult pulmonologist and get done 1. Clinical examination of respiratory system 2. Chest x-ray to rule out lung infection. 3. PUT (Pulmonary Function Test) for the diagnosis of bronchitis. PFT will not only diagnose bronchitis, but it will also tell you about severity of the disease and treatment is based on severity only. He will mostly need inhaled bronchodilators (formoterol or albuterol) and inhaled corticosteroid (ICS) (budesonide or fluticasone). Don't worry, he will be alright with inhaled treatment. Hope I have solved your query. I will be happy to help you further. Wishing good health to your son. Thanks.
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hello Doctors,16 months back I shifted to bangalore. Since then i have had nasal blockage nad very recurrent cold. But last 2-3 months, i am having severe breathing trouble. Have cosulted a pulmonologis and ENT as well. Was given some steroid inhalation. Breathing is normal while medication is on, but within a gap of a day or two, it comes back. Kindly suggest some solution. ### output:	Hello. Thank you for asking at Chat Doctor. I went through your history and would like to make suggestions for you as follows:1. Were I treating you, I would prescribe you regular montelukast and levocetirizine for nose symptoms. I would also suggest you albuterol inhaler to be used on as-and-when-needed basis for asthma symptoms/wheezing/breathing difficulty.2. For treatment of allergy, I would suggest you allergy testing which will help you identify the substances you may be allergic to and to know the measures to avoid them. Based on allergy testing, an Allergist-Immunologist may prescribe you allergen specific immunotherapy which works on immune system to improve allergy symptom on long term basis.3. In general, I would suggest you to avoid exposure to dusts, smokes and air pollution. (Air pollution is a big concern in Bangalore, I know).4. Regular breathing exercises and balanced healthy diet will help you to improve your lung capacity and immunity respectively gradually. Hope above suggestions will be helpful to you. Should you have any other concern, please feel free to ask at Chat Doctor. Wish you the best of the health. Thank you & Regards.
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hello, 28 y/o Cucasian male. Married, Very Healthy, Loyal/Monogamous. Intercourse frequency with wife (of course) is average to 10 to 18 times monthly. Sometimes more. I ve recently experienced an ejaculation with absolutely no semen suspension. Instead, just very gelatinous, white sperm (similar to the texture of scrambled eggs .) No saline odor, and the sperm did not lose stiffness/viscosity, even after 10 minutes or so..... as if it was too dry. I never ejaculate much more than about 2 or 2 1/2 cc any way, but today, about 1 cc pure white gelatin. My diet is good, my stress level is a little higher lately, and my wife and I have no known STD or GI or Gyn problems. What do you think? ### output:	Degree understand your concerns went through your details. I suggest you not to worry much. Water is the base of semen. About 90 percent of semen is water. Semen quantity decreases, and it becomes more viscous due to lack of water in the body, due to advance of age, due to frequent sexual practices, lack of affection and of course due to high stress levels. Such condition is not at all worry some and there will not be any change in the quality of sperm cells. Instead of worrying about such matters, be happy and concentrate on your career. Because that is not a problem at all. You might need psychological counseling. I can help you through telephone. Please do contact me through customer care of www.ChatDoctor .com for a telephonic consultation session. Hope this answers your query. Available for further clarifications. Good luck.
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: hello, this is the begining of my 6th week of 4th pregnancy after least menstrual period . married for 9 years i had a missed abortion of 5 weeks after 1.5 years of marriage and then after one year again concieved and a healthy baby girl arrived. then again after a gap of three years I gave birth to a healthy baby girl aged 3.2 now. so this is my 4th. doc prescribed two injections per week ,daily ascard and follic acid tabs. my questions why is it necesacry to take these progesterone n ChatDoctor injections this time. regards ### output:	Hallow Dear, Progesterone is a hormone required for stabilizing the pregnancy. This hormone is prepared in large amounts by placental tissue or the precursors of placental tissue. Before placenta is formed, it is the chorionic tissue which produces hormone Chat Doctor in large quantities to support the other progesterone producing tissues to produce progesterone. Hence, if there are any signs suggesting that the pregnancy is at risk, particularly early pregnancy, either Chat Doctor or Progesterone or both are given to stabilize the pregnancy. The signs demanding for these are mainly bleeding in the first three months without pain in the abdomen. Sometimes, if there is bad obstetrics history with previous abortions in first three months, these medicines are given as a precaution. If you do not have any such history of symptoms, you may not require Injection of Chat Doctor and/or Progesterone. However, please continue to take Folic acid which is very vital for the growth of the baby. I hope now you can take an informed decision.
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Four weeks ago, I went running--20 minutes later, it began hurting. It was enough to make me to keep the pressure off for a day, but I did all my normal activities with minimal dull pain. One week ago, my ankle swelled up pretty big. The next day I went to a walk in clinic, got an Xray, and the doctor said I was fine. He told me to wear a brace for a week. I have to walk back and forth to class every day (across campus, maybe a quarter to half a mile). The brace didn t give me any support--only made sure it wouldn t twist or turn on itself. The swelling hasn t gone down at all (it has been a week). Today it looks even worse, and standing on it has become unbearable. What should I do? ### output:	Hi, as you mentioned the swelling of an ankle, and your visit to doctor, x-ray, and brace. I see it more of an ankle ligament injury. That is the reason the pain is not coming down and also, you are having pain while standing more. Only an MRI can help us come closer to the issue. Ankle joint is the one first joint to bear the whole body weight so coming close to the diagnosis will be of choice with the help of an MRI. Also, rather doing all these, Try to pick bits of paper with your toes from the floor. It will help strengthen the muscles of feet. Also, understanding the biomechanics and pathomechanis of the foot is a wide area to explain, so care is important even in the smallest cases. X-ray can only show the bone, but the MRI will show the Soft tissues as well. I hope to see you, if you have any personal questions to ask.
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Yes m name is Doug and for the last 8 years I have been dealing with perherial neuropathy of my feet. And I am not a Diabetic. And I am on Medicare and there rules say that I do not qualify. I am almost seventy and ths last May my kidneys were not working and became toxic and was taken off a lot of medinces and one was my Gabentine and as soon as I stop taking it I went from a wheelchair to a walker and now I use my cane for keeping my balance. My feet are like 8 years ago tingling, burning and hurting. I have tried everything that I know and still the balls of my feet are bright red and noting seems to help. Salem, OR has very few neurologist and I willing to traveling to Albany, OR & Corvaliss. Can you give me ideas for treating my Periphal Neuropthy of my feet. I was diaaniost as that I have this problem by OHSU in Portland, OR. It is Idopathic progressive Perpherial Neurophay.Thanks for any help that you may have for me.God bless,Doug ### output:	Hi, Thank you for posting your query. It is unfortunate that you have severe peripheral neuropathy, and you are suffering because of it. For relieving burning and tingling, there are three good Chat Doctor. They are pregabalin, gabapentin and duloxetine. One of these can be started, and the dose titrated according to your relief and any side effects. I am sure you would improve with this treatment. I hope it helps. Please get back if you require any additional information. Wishing you good health,
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: hi doctoriam banu 28 years old ihave 2 male kids iam married in 2003.4days before i had throutinfection throut paining but now its cure.lost 3 days ihaving continous cough without sleep. check my docter chek me and told siviour veezing and give medicine. this is first time veezing for me.so iam doubt about veezing.pls clear my doubt about veezing ### output:	Hello Band, Thank you for asking at Chat Doctor. I went through your history and would like to make suggestions for you as follows:1. Wheezing can only be confirmed by listening to chest by stethoscope. So if your doctor has diagnosed wheezing, you can trust him/her for diagnosis.2. As you have first episode of wheezing, it can be due to viral infection. So you should not worry about anything serious at present. Such episodes improve with medicines and usually the patient completely recovers within 2-4 weeks. So I would suggest you to complete medications prescribed by your doctor.3. If you have repeated episodes of wheezing, in the future, then only one has to think about chronic diseases like asthma, etc.4. To make you understand "wheezing", it means whistle like sound coming from chest due to narrowed respiratory tubes (bronchi), which can be due to infections, bronchitis, asthma, and many other possible causes. Actually, wheezing is a sign and not a diagnosis. Hope above information will be helpful to you. Should you have any further query, please feel free to ask at Chat Doctor. Wish you the best of the health ahead. Thank you & Regards.
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: This morning I had a carton of tart yogurt. As I ate it, I felt the tingly feeling you usually get in the corners of the jaw when eating something tart/sour. Only it was ridiculously strong on one side, almost painful. My jaw on that one side (left) felt tingly and almost numb. When I looked in the mirror a few minutes later there was a large lump there, right in front of my left ear. It had not been there before. Since it s Sunday, I decided to wait a bit before rushing to urgent care. It s been six hours, the swelling has gone down but is still there a little when I touch or look closely. It s also tender there and below the jaw. Should I go to urgent care today? Or wait until morning? It s now 3:30pm. I m afraid of an infection or bells palsy or something scary. I should mention I went to the dentist for a cleaning 6 days ago and recently switched to a powerful toothpaste (which seems to have burned my tongue, affecting my taste a little ). Please advise. ### output:	You can wait till morning to report. The swelling needs an appropriate examination since you already visited your dentist just a week back this would not be due to an urgent dental complain as if so you would have been treated or informed of the same. Of the swelling in the external it appears to be due to some little blockage in one of your salivary glands or a rare thing can be allergy due to the toothpaste that you have been using. Since your toothpaste has already caused you problems I suggest you to revert to your original paste also avoid any sour and spicy food, eat plain salted things till you get your problem diagnosed.
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I have on c5-c6 central disc protrusion/extrusion measuring 4mm AP in combination with more dorsal lateral posterior ostteophytic spurring results in severe central canal stenosis . No frank spinal cord compression or cord edema . Moderate right neural foramina narrowing and mild left left neural foramina narrowing are present due to uncovertebral hypertrophy. C6c7 posterior disc osteophyte complex results in moderate to severe central canal stenosis. Near complete attenuation of CSF around cord is present . Moderate left neural foraminal narrowing and mild right neural foraminal narrowing are present . Neurologist said I need surgery right away. Is surgery my only option? ### output:	Hello are right in asking the question. The radiological report does indicate a status in which many physicians advise surgery and many patients get operated upon. However, the decision of surgery is not made completely upon the imaging findings. The clinical history and examination findings are the foremost things a physician keeps in mind. A patient with neurological deficits, like weakness of hands or feet, constipation, urinary complaints etc., is usually advised surgery straightaway. But patients who come only with pain and no compression of the spinal cord on MRI, are put on physiotherapy and medications first. Only if this conservative line of management fails, then surgery is advised. Most patients who comply well with the conservative line management are able to delay surgery for a significant period of time, or even totally prevent the need of surgery sometimes. Hope this solves you query... But remember, the physician who has seen you and examined you is usually the best judge... Take care...
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I have a disc problem a lower back disc separated in car accident . I am trying not to have surgery I have a lot of problems unbearable pain I had therapy, epidural,pain killers,muscle relaxers etc. nothing has helped could you please help me if you can give me some helpful advice I would appreciate it Thank you ### output:	Hello, Thank you for writing to Chat Doctor about your query, Brief Answer - Anti-inflammatory medication such as aspirin, Physical therapy, Steroid injections etc. Explained Answer - Conservative treatment of lower disc pain usually is successful over time. It includes:1. Pain medication or pain therapies such as ultrasound, massage or transcutaneous electrical nerve stimulation2. Anti-inflammatory medication such as aspirin, ibuprofen and acetaminophen3. Physical therapy4. Steroid injections5. Education in proper stretching and posture6. RestHowever, if your pain doesn't respond to conservative treatment in two to four weeks, your condition affects your bowel or bladder function, or if it threatens permanent nerve damage, your doctor may suggest surgery. The surgery usually includes removing the part of the disc that has squeezed outside its proper place, called a discectomy. The surgeon also may want to remove the back part of the vertebrae, called the lamina, In a laminectomy; or to surgically open the foramen, the holes on the side of the vertebrae through which the nerves exit, in a foramenotomy. Only about 10 percent of adult lumbar disc patients require surgery and even fewer child Chat Doctor. Hope You will find it out helpful. Thanks And
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: my daughter has a runny nose (very runny) and a fever that seems to come and go (worse at night). Those symptoms have been like that for 3 days. Today, she has a rash that disappears and appears in different spots fairly quickly (sometimes disappears within a half hour ### output:	Hello, From the information you provided, I think that these are signs and symptoms of a common viral infection. Rash could be due to fever. Therefore, please do the following to manage the condition of your infant:- Apply physiological isotonic water to your infants nose (to each nostril) for 2-3 times a day. This simple and cheap procedure will improve her nose condition and will ease nose blockage by secretions.- If your infant is 3-6 months old, apply paracetamol, 10-15 mg/kg/dose every 4-6 hours. If your infant weight 10 kg, then you can give between 100-150 mg of paracetamol every 4-6 hours.- If your infant is more than 6 months old, paracetamol could be alternated with ibuprofen in order to dominate fever. Ibuprofen is given 4-10 mg/kg/dose every 6-8 hours. If your baby weights 10 kg, then you have to give between 40-100 mg of ibuprofen every 6-8 hours.- Keep your baby well HY Chat Doctor. Please monitor your baby for another 2-3 days (usually viral infections last for 7-10 days) and if the condition does not improve, fever is not dominated or there are signs of laryngitis (
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: My husband has been feeling dizzy for 4 weeks. No other symptoms as far as I knew. I sent him to the doctor who after a bit of investigation decided it was probably a viral infection. BP 120/70, a febrile. Bloods not yet done. Tonight my husband showed me a non healing woun on his forearm. Smells very much like psuedomonus. Wound has that bright red meaty look. Small amount of slough. I suspect this is the cause of his dizziness. Could this be correct and if so what are the complications of having pseudomonas in his body for such a long time? (I am a nurse by the way). Will get swab done and antibiotics tomorrow. Of course this costs!! Stupid me. ### output:	Hello! Welcome on Chat Doctor! I read carefully your question and would explain that the infection in his forearm and his dizziness do not seem to be related. It is really less probable that dizziness may come so long before the local infection being visible. But, as it is an infection, I would recommend consulting with his doctor for a physical exam, a bacterial culture of the wound material and a complete blood count. It is important to determine the infectious agent, in order to choose the best treatment options. Regarding the dizziness, I would recommend performing some tests: - a cervical spine X-ray study for spondylarthrosis- labyrinthine tests for an inner ear disorder- a brain MRI- a Doppler ultrasound of the vertebral arteries to exclude possible vertebral artery insufficiency. Hope to have been helpful! There is no need to pay for these answers as they are free.
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I had jaundice in Sep 2012.at that time i had sgpt of 285&bilirubin of 4.5.after two month I had sgpt of 123 bilirubin below 1.i have been on diet control till feb 2013.on 30th march I had fod poisoning &b i had bben hospitalised for a day .I had a blood test & ihad sgpt of 121,spot of 75.I had bein detected fatty liver in utrasound test. what preacaution I should take to bring sgpt to normal level&sugges food .can i do exercise &play ### output:	Hello,jnanprakashlall62,Thank you for contacting Chat Doctor with your query. In Sept.2012, you say you had jaundice and sounds like Hepatitis of some sort, either Type A, B or C. Usually Type-A hepatitis doe snot go into a chronic phase. The other two cans. Your bilirubin level has come down to normal and SGPT and GOT are still elevated but seem to be improving. Now you are told about fatty liver. I am not sure if the doctors told you what grade it was. I have a feeling it improbably mild. At this stage, it can reverse back to normal. Do not Chat Doctor. These include NSAIDs such as Naproxen, Ibuprofen etc.Also, certain antibiotics belonging to the sulfa or tetracycline family. You need to avoid highly fatty, greasy foods and fried foods also. You can take supplemental protein
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I have a question. I am currently receiving treatments from an orthodontists. I have an impacted front tooth that I want down. Initially, during the consultation, the doctor told me that in order for that tooth to come down, I would have to get braces and then a surgery to expose the impacted tooth and to chain it. He also said that because the tooth is in the front, he would put a temporary tooth in that place while he uses the chain to pull the tooth down. Well, I ve got the braces and I had the surgery. All I m waiting for is for the doctor to pull it down and to put a tooth in the front. Well, during my last appointment, he told me that he wasn t going to be able to pull it down because my surgery area wasn t completely. Now, the surgery area is healed, and I went to see him today. I was expecting to begin pulling my tooth into place. However, that was not the case. He told me that, now, in order for him to begin to pull down the tooth, he has to leave the open space, and I would have to go a few months without a tooth in the front. This is not what I agreed to initially and I do not want to walk around like that. Is there anything I can do about this? ### output:	Thanks for your query, I have gone through your query. The tooth cannot be replaced with an artificial tooth since in that place the impacted tooth has to be pulled down. By placing an artificial tooth, we cannot pull the impacted tooth into position. So ideally speaking, the impacted tooth should be exposed and then using braces it has to be repositioned. Do not go for artificial tooth. I hope my answer will he LP you, take care.
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: MY SON IS 3 AND HALF YEARS OLD. HE DOESNT TELL US IF HE WANTS TO PASS THE MOTION AND IF DOES IN HIS UNDER PANTS THAT ALSO HE DOESNT TELL US. HE KNOWS THAT HE HAS PASS THE MOTION BUT I DONT KNOW WHY HE DOESNOT TELL US . HE JUST STAND STILL AND WHEN WE COME TO KNOW THAT HE HAS DONE THE SHIT HE DOESNOT COME WITH US TO THE TOILET. I HAVE TO SHOUT AND TAKE HIM TO THE TOILET. PLS CAN YOU HELP ME FOR THIS THING . I DONT KNOW WHY HE DOESNT TELL ME INFACT HE DOESNT COME WITH US TO THE TOILET TO CLEAN IT. ### output:	Hello and welcome to Chat Doctor. The behavior your child is exhibiting is encopresis (pants soiling). Most commonly it is due to Fear of loo which develops secondary to Painful def evasion (bowel movements). Painful defecation most commonly is due to constipation. Treatment involves removal of impacted stools from gut by giving enema or glycerine suppository (medicine given via anus)After that constipation is treated by lactulose syrup and increasing fiber and water intake. Also get your babies' rectum (last part of large gut)checked by pads surgeon. Treatment also involves behavior modification for bowel movements and fear of loo. It is done by psychotherapist Hope you find this answer satisfactory. Good luck.
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hi. I ve had chronic shivering/judder type of symptoms since i ve been young. Everyone around me notices that when my hands , or arms are active, for instance when passing lightweight (not even heavy) objects to someone, my hands will tremble. I notice this in my legs too. It often always occurs when my body is active, even slight gentle movements cause it. When i was younger i did not worry so much & assumed i may overcome it. However, i m 25 now and it effects me socially as well. I want to find out whether it s something associated with my nerves internally, or if it s psychological. I m a healthy 25 years of age female individial, don t smoke , don t drink, healthy weight, i ve never had any other health issues. I have a fairly healthy diet too. Take vitamins sometimes as well. I don t drink coffee, just tea. If you can provide any possible directions, or ideas for me to consider, i will appreciate it ### output:	Hi, Welcome to Chat Doctor forum. I understand your concern. Fine tremors are associated with few medical conditions such as nervousness, thyroid overactive state, vitamin deficiencies especially vitamin B12 and rarely neurological condition. If you haven't yet seen a doctor for this problem, I would encourage you to visit your physician. A little blood test will help us to know about your problem completely. We can then manage your condition accordingly. The test performed would include tests for vitamin deficiency, thyroid levels, other hormone assessment and neurological evaluation. A small dose of beta blockers can be prescribed to treat tremors and improve your quality of life. Hope this answer is informative. Wish you good health. Regards
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hi, I get mild chest pains in the left of my upper body from the middle of my chest to under my arm pit where I experience constant discomfort. Sometimes it feels like heart burn whereas other times my chest feels tight and constricted. The symptoms vary with intensity throughout an average day but they are worse after drinking alcohol. My doctor has prescribed me a few different medicines related to heart burn which as yet have all failed to remedy my symptoms. Any help, small or large would be much appreciated, Thanks and kind regards C Rutter ### output:	Hi and thank you for choosing Chat Doctor to share your concern. I read carefully your question and I agree that this kind of chest pain has the characteristics of a chest pain related to Gastroesophageal reflux and the times your chest feels constricted and tight it relates to epigastric spasms. It would be good to know what kind of medication and what dosage your doctor prescribed and understand why they didn't gave results on you. The treatment is based on lifestyle modification and control of gastric acid secretion through medical therapy with antacids such as Sanitizing, proton pomp inhibitor such as omeprazole and in extreme situation(which i don't think is your case)with corrective antireflux surgery. Lifestyle modification include :Elevate the head of bed Avoid eating for several hours before sleeping Reduce weight if you are overweightAvoid caffeine, nicotine,alcohol multiple small mealsSince the list of food and beverages is extensive it requires ti do a personal journal of dietary intake and symptoms. Hope my opinion is a help to you. Wish you good health Kind Regards Chat Doctor.
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hello Sir, My brother is suffering from cerebral palsy since his childhood. He is continuously getting fits and right side hand and leg are affected. He is 30 yrs now. We have been using both English medicine as well as ayurdic medicine. However, fits did not come into control. Past 6 months, fits are coming almost twice a day. Recently we went to a Doctor and he suggested us to use Carbatol 400mg and Lacoset 150mg. Good that he did not get any fits in these 20 days. But, 2 days back, suddenly he feels some problem with his right leg and couldnt use his leg as before. With great difficulty he moved his leg. But as hours passed, it became better but still problem exists. We were afraid it might be beause of the new medicine. Doctor confirmed that it is definetely not because of the medicine and gave a new medicine TOLIFAST 150 and continue for one month. He said it happened due to severe cold . We are worried about the situation. Kindly please suggest. Thanks, Lakshmi ### output:	Hi, Thank you for posting your query. Fits can be brought under good control with medications in most patients (about 70-80%), in the rest, surgery may be required. Carbatol and Lacoste are good medications to control fits and seizures, and should be continued. The side effect of leg weakness is not due to these Chat Doctor. He would require anti-seizure medications for whole life, as the brain damage resulting in fits are likely to remain throughout life. In addition, please do active physiotherapy to improve the leg function. I hope it helps. Please get back if you require any additional information. Wishing you good health,
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hello Doctor, My mother is 55. She has severe rhe arthirits since 20+ years. She just had acute renal failure 2 wreks ago. Also have high blood sugar, potassium level was also high When tested doctor said have ureasepsis so she had dialysis for 3 days. After 3 days of dialysis when blood tested found urea high in blood around 43. So once again got dialysis done. She is still in ICU. Dont know what to do. Doctors said she needs to come twice a week for dialysis. But before and after dialysis she gets so weak that she cant even open her eyes.Please Help Doctor ### output:	She is feeling weak after dialysis because they are removing too much fluid from her body during dialysis. Discuss with your doctor to see if removing less fluid or not removing fluid from her body will prevent her from feeling weak. In disease of kidney caused by painkillers used in rheumatoid arthritis, patient tend to pass a lot of urine compared to other patients and hence many a time only dialysis is required and little or no extra fluid needs to be removed during dialysis. If your mom has pain still discuss with your doctor if she will benefit from steroid and leflunomide. The chance of your mom recovering is high if the creatinine increase is recent. However, for predicting chances of improvement more information is required. Discuss with your doctor if she will need a renal biopsy in the near future. It can predict recovery better than other tests. However, if the kidneys are severely damaged and small biopsy is dangerous and treatment has to done without kidney biopsy. Wishing fast recovery for your mom. Hope the information helps.
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: hello, I was cleaning and working up a real sweat. I bent down to pick up something and when I stood up, my heart felt like it was flopping around. I got freaked out and my anxiety started to really act up. I went to sit down and had a drink of water, trying to cool down, and it started up again for a few seconds. That freaked me out and I had a full out anxiety attack, and started shaking and hyperventilation. Now im freaked out and keep pacing around, im not sure if its going to happen again. With my last pregnancy, i was on metoprolal(spelling) cuz i had heart palpitations frequently and I didnt want it to be anything serious. I had a ultrasound done on my heart in sept 2009, and my cardiologist said my heart structure was nice and strong. I am going through a lot of stress between work and home, and i am currently on .25mg of alprozalom 2 times daily to help with anxiety. But today really freaked me out! ### output:	Hello, I passed carefully through your question and would explain that your symptoms seem to be related to anxiety. Nevertheless, I recommend checking some blood lab tests: - complete blood count-thyroid hormone levels-blood electrolytes. An ambulatory 24-48 hours ECG monitoring would help examine your heart rhythm trends for a prolonged time and exclude possible cardiac arrhythmia. In the meantime, I would recommend practicing Yoga and meditation. It is not recommendable taking alprazolam for a long period of time, because it can lead to addiction and tolerance. Hope I have answered your query. Let me know if I can assist you further.
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: my friend is an asthamatic patient suffering from childhood. He takes continous doses of capsules of deriphyllin to get instant relief. e has become more irritability & frustrate & gets angry soon. Please recommend any good asthamatic institution or any relief inhaliers other than asthalin. ### output:	Hello. Thank you for asking at Chat Doctor. I went through your friends history and would make suggestions for him as follows:1. I would suggest him regular montelukast and inhaled corticosteroids for at least 3 months. Furthermore, I would also suggest him to use albuterol (Stalin that he is already using) inhaler on as-and-when-needed basis.2. Furthermore, I would recommend him allergy testing and consult an Allergist-Immunologist. This will him identify the substances causing allergies and also to know the measures to avoid them. Based on the report, an Allergist-Immunologist may prescribe him allergen specific immunotherapy which works on immune system to gradually improve his allergy symptoms on a long term basis.3. In general, I would suggest him to avoid exposure to dusts, smokes and air pollution as much as possible.4. I would also suggest him regular breathing exercises and a healthy diet rich in vitamins & minerals (adequate amounts of green leafy vegetables, fruits, sprouts, etc.) to improve his lung capacity and immunity gradually over a long term basis.5. Deriphyllin is a very commonly used Chat Doctor. Hope above suggestions will be helpful to you. Should you have any further query, please feel free to ask at Chat Doctor. Wish your friend the best of the health. Thank you & Regards.
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I have had problems for the last few months with swelling and pain when I move in my right knee. A doctor told me that it looked like arthritis in the knee. Yesterday, all of the sudden I had great pain while walking and when I got home, I noticed that there was a protrusion on the outside of my knee like a lump which was hard. The lump itself is not painful, but my leg aches and it is still very painful when I bend my knee. What I am wondering is this just another aspect of the arthritis, or should I have my knee looked at. Thank you for your advice Kathy ### output:	Brief answer:See detailed answer. Detailed Answer:Warm Welcome. I appreciate your trust in Chat Doctor and assure you are on best portal on the globe for expert online medical services. I have thoroughly reviewed health query you raised, and well realize all of those concerns. Being your physician, I will take care all of them today and will extend my expertise to solve the problems. Based on what you said, knee lump may be due to arthritis, infection or bakers cyst. You are advised to see your nearby orthopedic. If I were your treating physician, I would first order an x-ray, took a synovial fluid sample for its detailed examination and an ultrasound scan for lump. Once the cause is pinpointed, a detailed management will be devised for you. Until then, you may take tab. Naproxen 20 mg once daily for pain relief. Hope I ad Chat Doctor. Let me know if you have further questions. I will be more than happy to clear any doubts. Keep a follow-up to see how you're doing. Regards!
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: hi, last monday 3rd June I slipped on a wet area in bathrrom falling sideways onto the outside hob of shower, not drunk either. My head is cut but healing but my right chest & back area is still severely painful. Breathing is slowly improving but difficult to lay comfortably in bed without 6 pillows, propping my left side high to take the weight of my arm off my chest & back area. I doubt i have broken a rib but it sure feels like it. I am better walking around slowly than lying which makes me ache & stiffen . the 1st 3 dys i laid in bed but now i am walking around slowly. could this till be a rib repairing or bruise??? If i went to hospital & managed to get an xray which they are always very hesitant to do usually only with insistence, i still prob would only be told to rest as no treatment for broken ribs. Yes I have had b4 many years ago, the lower 3ribs in a car accident. any advice would be appreciated. ### output:	Hi and thanks for this query.i am sorry to hear about this bathroom accident you suffered. Knowing the exact problem is always a plus. The management of broken ribs if often rest and painkillers but not ALWAYS. If the X-ray should suggest a broken rib and reasons to operate upon, like the edge is pointing to the skin or the heart or lungs, then operating upon to align it is possible. So, please go and get the X-ray done. At worse, it will provide answers and reassurance/assurance. If you should not feel better soon, then going to the hospital is a better option. Hope this helps and answers your question. Feel free to come back to us for more answers. Cheers
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I have itching and burning inside my mid right side of back, around the kidney area and extreme pain coming and going in intensity for past week. I have burning during urination but urologist says no kidney infection from urinalysis. paid gets so bad bring tears to my eyes. ### output:	Hello Welcome to Chat Doctor. Thank you for posting your query here and I'm definitely going to help you out. I being a surgeon, we encounter so many such cases and it's not a major problem, so suggest you not to worry. I read your question completely and have understood it well enough. Furthermore, I will analyze all your points. 1. You say you are suffering from itching and burning sensation in the region of kidney. Want to know if its pain!? If yes pain then in all likelihood you might be having Renal Calculus. I'm not scaring you, but please get a Renal USG scan. This will tell us if there is any kind of stone, whether there's hy Chat Doctor. . 2. Burning sensation during micturition, again indicates urinary tract infection, UTI. Well, your doctor might be right, but please confirm yourself. Get these 2 tests done. A. Urine routine and microscopy B. Urine culture and sensitivity. 3. Urine culture will grow any organism causing this UTI. If nothing grown then chances are low. If there is bacteria, we can always give sensitive antibiotics and clear the disease. 4. So basically, get all these done. USG scan, urine routine and culture. 3 things. Later we can manage your problem easily. Hope this helps you, in case you need any further assistance. Please let me know. Take care and God bless you.
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: Hi Doctor,My mother has been diagnosed with cancer. The OB-GYN told us that it is Ovarian Cancer and that there is already a spread to other organs in her body, particularly the wall surrounding her intestines. Suggested treatment is chemotherapy. But my mother is a bit hesitant, considering the pain that she is experiencing right, she might not withstand the side-effects of the procedure. Based on the result of the biopsy, as follows "ENDOMETRIOID ADENOCARCINOMA, MODERATELY DIFFERENTIATED, Both Ovaries. Extent of Involvement, Both Fallopian tubes and Omentum. Lymphovascular Invasion. Present in the Cervix and Endomyometrium. Other Findings: CHRONIC CERVICITIS with NOBOTHIAN CYSTS. SECRETORY ENDOMETRIUM.", how would you stage her cancer and what treatment would be possible aside from chemotheraphy? Thank you,Francis ### output:	Hello dear, thanks for your question on Chat Doctor. I can understand your situation and problem. By her reports, your mother is having stage 4 ovarian cancer. Her cancer is already spread to intestine, so she is having end stage cancer. The only treatment advisable is palliative treatment in the form of1. Chemotherapy2. Radiotherapy3. Nutritional support4. Pain management. Surgery is contraindicated. Did effects of chemotherapy are high. So you need to be very cautious about starting it. Life expectancy without chemotherapy islets than 1 year. So better discuss in depth about chem chemotherapy and then decide accordingly.
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: 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 cant get to the potty fast enough when I need to urinate. Im scared and Im making an appointment to see a urologist. Should I prepare myself for cancer? ### output:	Hello and welcome to Chat Doctor, 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 care Chat Doctor.
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: hi my dad is haveing a angiogram tomorow hes 63 and diabetic and he has bin takeing warfan tabs 4 a very long time now but hes off of them for the last four days count on haveing a angiogram tomorow,im really worried bout this angiogram will he be ok?its really worring me and my family even my da is worried ### output:	Hello Welcome to Chat Doctor You have not mentioned here why is he on warfarin. Warfarin is a blood thinner which is prescribed if a person has propensity to develop or has developed clots in the legs, in patients with irregular heart rate (AF) and in patients post valve replacement. I would be in a better position to help you had you provided the details. Coronary Angiogram is done to evaluate presence of blockages in the heart. On BAII of the findings of angiogram you may be suggested either medical management, or angioplasty or bypass surgery. Angioplasty can be done if there are short blockages on the arteries. It is a 1-3 HR procedure that can be done in the same sitting and the patient usually gets back on his legs on the next day. Bypass surgery is advice when there are multiple widespread blockages involving the major arteries of the heart. Bypass surgery requires planning, patient preparation etc. Again it takes about 4 days to patient to be back on his legs and some 20 days to recover totally. But the long term results of bypass are very good. Since he is diabetic he has a tendency to develop heart blockages so be prepared for an angioplasty if suggested. I suppose I have answered your queries satisfactorily. Wishing him good health. Regards
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I have had a single bypass with serious occlusions of other arteries that could not be bypassed, trying to control with medication. Right ventricular with a stint is now completely occluded. What are the best treatment modalities can be used to dissolve the plague ### output:	Hello! Thank you for asking on Chat Doctor! I understand you concern, and would like to explain that when judging the need for a new revascularization procedure, a comprehensive guide on decision-making would be the recent clinical symptomatology (is there evidence of ischemic angina or its equivalents, etc.), coupled with some functional and some imagine tests. Besides coronary angiography which is the standard for making evidence of coronary artery lesions, other tests like traditional exercise stress test, or any available myocardial perfusion imagine test (like for example Cardio lite, etc.), may be helpful to identify the possible ischemic consequences of any new coronary stenoses (confirmed on coronary angiography). If new coronary stenoses are present (on coronary angiography), and no collateral circulation is compensating blood supply deficits, coupled with clear evidence of myocardial ischemia (on perfusion imagine tests), then a revascularization procedure should be considered. Probably facing your prior medical history, the best revascularization option to be followed would be a percutaneous coronary angioplasty with eventually stent implantation. Nevertheless, the latter discussion is almost thoroughly a technical one, and depends on also by technical skills of the medical team, as well as by available techniques at the attending medical center. You should discuss with your attending cardiologist about the above-mentioned issues. Hope to have been helpful to you. Greetings!
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: For a few months now, Ive been getting tiny itchy red bumps on my labia majora. Im not sexually active but I was a couple months before it started happening. I went to the doctor a few times. The first time they said it was a bacteria infection. The symptoms came back and I went back a second time about two months later. The gave me the same treatment. About three months later, the itchy red bumps were back again. I went to a different doctor and got check again. I got a pap smear and blood drawn. Everything came back negative so the doctor gave my a jock itch cream. I was wondering if you could give me any answers because I dont think they know. Can you please help? ### output:	Hi there, Thank you for reaching us. I understand your problem. Though you are not sexually active now, but you might have acquired a sexually transmitted disease(through oral, vaginal, and anal sex), when you were active. This most probably is due to a virus named Herpes simplex, for this you need antiviral treatment. Secondly it might be due to sensitivity to chemicals or irritants(contact dermatitis), or caused by allergies (atomic dermatitis). You should visit a gynecologist for this. In the meantime avoid known irritants, such as abrasive soaps or strong fragrances. You may find some relief through a site bath. This helps to relieve any pain and discomfort associated with the sores. This can be done at home by filling the bathtub with warm water that goes up to your hips. You may add a mild saline solution or baking soda to the water. While you can purchase small basins for site baths from a Chat Doctor. Hope it helped. Take care
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: i have 2 stray cat comes to my house for food everyday and one day i try to pat one of the cats head and she got startled and bit me and scratched me on the hand and i was bleeding a lot . This happened to me in Jan 15, 2012 which is sunday. The cat bite start to feel itchy in Jan 16, 2012 but i feel nothing in cat scratches and i went to the doctor today which is 1/27/2012 my doctor looked at my cat bite and she went to my list saying i had tetanus shot many years ago and she did not give me any shot. She told me to go to the pharmacy and i got antibiotics tablets and i had to take them but i am still worry about my health. I dont think i trust my doctor. ### output:	Hello, Welcome to Chat Doctor, Cat is a known reservoir of rabies virus, and it has got all the potential to transmit rabies which is 100% fatal, but it is 100% preventable by proper and adequate treatment. As there was a bleeding following cat bite, according to WHO categorization this is categorized into Cat III, which should be manged by1. Wash the wound with soap and water.2. Active immunization with anti rabies vaccine on days 0,3,7,14 and 28.3. Passive immunization with anti rabies serum around the wound.4. Oral antibiotics like Tab Augmenting, 625 mg, twice daily for five days. The aforementioned measures should be followed to prevent rabies in you. Thank you.
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I have had a fever for 19 days. I dont have mono. The results are not in for my CMV levels. My b12 is very low. I had a swollen throat on the left side for the first few days and it went away. It is not getting a bit swollen and sore on the right. My only symptom is being extremely tired. I started taking b12 and am not as sleepy but my body is still so tired and sore. My spleen hurts, and has ruptured before but encapsulated itself. Any ideas? I am going back to the doc tomorrow morning to get a b 12 shot and the cmv results. The cause of the previous spleen rupture was cmv... ### output:	Hi Dear, Welcome to Chat Doctor. Understanding your concern. As per your query you have symptoms of fever with extreme fatigue this seems to be viral fever or flu. It happens due to poor immunity of body. Need not worry. I would suggest you to take anti-inflammatory medications such as Ibuprofen to prevent fever and body-ache. Chat Doctor. You should take muscle relaxant as well. You should do warm saline gargles on daily basis. Avoid cold carbonated liquids. You should not take fried, hot and spicy food. Do warm saline gargles. Take analgesic and take light diet. Your symptoms will resolve in 3-4 days. If symptoms keeps on persisting visit general physician once and get it examined and start treatment after proper examination and prescription. Go for blood tests as well. Hope your concern has been resolved. Get Well Soon. Best Wishes,
If you are a doctor, please answer the medical questions based on the patient's description.	### instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### input: I have two adult children in my home who have both been diagnosed with mental illnesses. My son is under treatment, but my daughter is not, and in the last 16 months, she has brought havoc to my home. She has taken over my dining/living rooms, and part of the kitchen with things that need to be recycled or thrown out. I have gone through the process to have her committed, but despite a diagnosis of bipolar/schziod affective disorder, the jury would not mandate treatment since she didn t met one of three conditions; harm to others, harm to self, or unable to care for herself. I can take her to court to have her evicted which will take 45 days or more, and puts her out into the streets again. She was originally diagnosed in 85 and went into treatment through the courts, but has not been on meds or in treatment since 88, and has been homeless many times when she didn t have a place to stay. I m 69, retired and tired of taking care of both my children. Their father died in 83, there isn t family that are able to help, and they definitely hawith me for three months. I love both my children, but I need my space and place back, and they need to be more independent as possible. Mother of Two ### output:	First of all, only psychiatrists and psychologist can decide and not the jury directly whether any treatment is required-there should be re-appeal in court and one may seek help of human rights activists and agencies. Secondly, the helpless child Chat Doctor. There are spiritual counselors as well who could guide them to some self-faith in themselves. Resperidone is a medicine which can help so consult a psychiatrist in your area