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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: Dr. I am 42yr male, 5.8" Hegitht, 70kgs weight from Bangalore.. I am washing penis once in 15 days & mine is tight to to pull & push outer skin. 6 days back all of a sudden i got itching & pus was coming , there was a little bruise below my penis cap & I went to my physician & did urine & blood test which was normal & he gave antibiotic & the pus releasing stopped.. He said it is local infection. I am using SAAZ 500mg for my back pain.My question is :1. Why is this infection2. Will this again arise 3. Is there is a cleaning procedure of penis4. Give me best doctor in bangalore near to malleswaramPls. help ### output:	Hi, 1. Infection of penis that is persisting is indicative for:- lack of success of previous infection- a culture of pus coming from penis is recommended to determine the type of microbe causing the infection and appropriate antibiotic to fight it correctly-apart local hygiene and medications, you should be use oral antibiotics for long time-should avoid sexual intercourse until improvement- if not circumcised, please discuss with urologist to get circumcision as definite treatment-get your partner tested and treated adequately too2. If treated correctly, it won't get again arise3. You can continue as advised by your urologist. However, systemic/oral treatment is highly recommended4. You can ask your physician to refer to the urologist in hospital and get a more specialized medical attention there. Hope it was of help! 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 there, my name is Natalie. I am a 55year old working full time in a retirement village at present. About 2 months ago I had a Gall Bladder attack which I sort medical attention for. After doing blood and urine testd the doctors confirmed blood in my urine. I had to go for CT scans on my kidneys of which they found nothing. I had another urine test which still showed blood in the urine so I was sent for Ultra-sound tests. Still nothing? Although I feel okay at present, after long periods of reflection I remembered having these pulsing sensations in my mid back(where the kidneys sit). I still have these sensations now. I often get a dull ache throughtout the day as well. On reflection I recalled having Brights Fever when I was 2yrs old. I also developed Rhuematic Fever at the age of 11 which lasted through to around my mid 20s. I am a person who likes to keep fit and I very rarely take pharmacutical drugs, I take natural products instead. I have been wondering if the Brights fever could be connected to this condition that has developed now with blood in my urine? And I do now frequently get up to the toilet during the night. ### output:	Hello and welcome to Chat Doctor, Hello and welcome to Chat Doctor, Blood in urine suggests renal pathology. Some renal diseases can cause blood in urine. A renal biopsy will help to diagnose the condition correctly. Further management will depend on the finding of the renal BIOS. The pulsing pain on the back can be secondary to the cardiac problem. You need to consult your cardiologist for further investigations and management. 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: had 3 total knee replacements, with infection coming back each time. Finally had rod inserted from my hip to ankle, so i cannot bend leg at all. I am in extreme pain all the time, the next step is to amputate leg from knee down, at least i could walk. I am 62 y/o male who used to be active ### output:	Hello, Firstly, sorry to hear about the 3 knee replacements then now amputation. It's a big pain I can understand that. Coming to the query, well below knee amputation might work if you're having gangrene or necrosis of the limb due to uncontrolled sugar levels. Also, before you undergo amputation of the below knee I would recommend that you first need to strengthen the other joints of the body leaving the amputation limb. Because post amputation your upper limbs and the other lower limb will be supposed to take the whole body weight and if you are weak in that state it will be difficult to make you back on feet. To overcome the helplessness situation I will recommend getting the strength in the upper limbs and the other lower limb so that the recovery post surgery will happen faster with less pain. In my clinical practice of over 12 years most cases seen by me of amputation I have always advised and worked on the other limbs and joints to make them stronger. In about 90% of cases the post surgery recovery is excellent with 10% who were not taking the exercise as that important as the surgery. I hope you will take the wise decision now to take the exercise beforehand to get prepared for the post Surgical recovery. Hope I have answered your query. Let me know if I can assist you further. Jay In 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: i found a pea-sized lump underneath the skin of my 1-year old on her rib cage near to her breast. the lump was directly underneath a bruise. what could this be? we took her to a pediatrician who was perplexed and ordered a blood test and x ray. thank you. ### output:	Hi, Dear thanks for the query to Chat Doctor virtual Clinic. I studied your query in all the details put forth by you. I understood your health concerns. My replies are as follows-The problem of lump below the breast with bruise over it needs more information-As to how long this lump was there? How long is the bruise over the lump?if it hurts on pressure? Any recent fever/or viral infection ? Cause of the health problems you queried-In the given situation, when the pediatrician has examined and has ordered X-ray and blood test, I would advise expert opinion from ER Surgeon, who would rule out many other reasons for such a pea-sized lump. As I don't have any photograph of the lump or any direct examination data, its very difficult why your doctor advised x-ray and blood tests. You should wait for the reports and to plan treatment from your pediatrician on the lines suggested to you and get second opinion from ER Surgeon doctor. Hope this would resolve your query with full satisfaction. Welcome for any further query in this regard to ME by direct question at Chat Doctor. Write excellent review and hit thanks, to narrate your experience, which would improve my rating for many other visitors to Chat Doctor. Wishing you fast recovery. Have a good day. Chat Doctor. N. Senior Surgical Consultant. M.S. Genl-CVTS
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 child has a high fever for last one weekon monday doctor diagonise typhoidfirst they give cefixime 100 mg 3.5 ml twice a daywednesday we consult another doctor and he doubled the dose with crocin after every 6 hrsbut once we spotted some blood accumulate and then we gave his stool to lab and there was also some blood accumulatesthen we rushed to hospital for admission but doctor told us there is no need instead he started 150 mg vaccine in 10 ml distilled water. along with antibiotic cifloxin( 5ml twice a day) and lansoprazole tablet once a dayfor fever he recommended us crocin and neftal after every 8 hrs alternativelynow his fever is normal. but is not having his meal properly and feeling dizziness and is not active.earlier when we were giving him oral he shows active ness once hsi fever was normal after having crocin.pls suggest are we medicating him properly ### output:	Hello This is over consciousness of the parents of the child. As you stated that your son is getting ciprofloxacin (dose must be 10 mg twice in day) for 14 days. While your doctor I also advised lansoprazole for nausea and hyper acidity. While Cronin and metal are also for fever and pain. All standard treatment has prescribed for your son, so need not worry. Mild blood in stool is a characteristic feature of typhoid fever, so need not worry because typhoid fever is intestinal disease. Within short period your son will resume his normal activities. Be confident and nothing to worry.
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 who is 15 months keeps getting coughs that are really bad every 2 weeks. The doctors said it is junior asthma but even with the steroid inhaler there is no change and every couple of weeks it returns. his appetite remains (which is very healthy as he us a big boy) in the day he struggles and it is worse at night. I do not think it is asthma and I am worried please help. Regards Richard Smith ### output:	Dear Mr Smith, Reading your query it seems that your 15-month-old son is having upper airway problems both during the day and night, but worse at night, and you do not think the steroid inhaler has helped. Nocturnal cough has many causes, such as gastroesophageal reflux disease (i.e., hyperacidity) that respond to acid lowering agents (such as Davison (UK), or proton pump inhibitors (omeprazole etc.); and then junior asthma that responds to as required albuterol inhaler (but you need steroid inhalers as rightly prescribed if that happens during the day as well); and of course, allergies that need excluding. Asthma in little child Chat Doctor. If he has wheeze during the day when he is playing (i.e., exercise-induced asthma), a trial of montelukast can be recommended. If there is history of eczema and family history of allergies, skin testing (or specific IGE blood tests) is important to exclude common household allergens such as house dust mite, cockroach etc. and specific treatment (including avoidance strategies) can then recommend. I hope this is useful. 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: had what i thought was a tooth ache and whent to the dentist he removed my lower left wisdom tooth it had some decay 2 days ago. Still have some pain lower left jaw and left ear and down left side of neck pain changes from mild to wow that realy hurts. wondering if only a tooth problem or more ### output:	Hi. Welcome to Chat Doctor . I have gone through your query and can understand your concern... As per your complaint and presentation of symptoms if you have got a tooth extracted then pain after 2 days is not an abnormal finding and if the pain is due to extraction then it will gradually resolve as the healing will proceed considerably. But in your case if the pain is progressively increased and the area to which the pain is radiating that is lower left jaw, left ear and side of neck it seems that there is some disorder related to the jaw joint known as TEMPOROMANDIBULAR JOINT and such a disorder is known as TEMPOROMANDIBULAR JOINT DISORDER. I would suggest you to wait for one week so that the healing of the extraction socket takes place so that the exact cause can be ruled out as if pain subsides after healing then it is due to the extraction socket. In case if still the pain continues then you will have to consult an oral physician and get evaluated and get a full mouth x-ray known as ORTHOPANTOMOGRAM [OPG] done so that he can evaluate the condition of the jaw joints and make a confirmatory diagnosis. As of now you can take anti-inflammatory painkillers like Ibuprofen and muscle relaxant like Chlorzoxasone for relief. Hope this information helps. Thanks and 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: I am a teenager and i have been feeling kind of depressed for a while, so i took some online tests and they said i have a high chance of having dysthymia. I read some articles about it and it seems to describe almost exactly how i feel. All of the stuff online says i should be getting help, but i really dont think its that big of a deal. Im not suicidal or anything, and i really dont want to make my family pay for any medicine or therapy. Its not like its totally ruining my life, im just feeling kinda down. Should i go to my school guidence counselor, or just kinda see how things play out? Our health class is doing depression screening in about a month, so if anything is really wrong they will find out and tell me what to do i guess. I just dont know if this is serious enough to make a big deal out of it. I know my parents would either think im making a big deal out of nothing or they would overreact and get super upset.Any advice? ### output:	Hi, You are a teenager, and the hormonal changes you are normally experiencing (involuntary) do play a role in your mood changes. It is perfectly normal to get those feelings: sometimes hopeful, some others hopeless. However, keep in mind that this is a transitory period due to hormonal changes. You should cheer up and enjoy your life. You have no reason to get into depression, although you might be feeling down. Go out and walk or run or swim; in other words, do some physical activity that could help you "explode" in order to get out all the negative impulses inside you. Being physically active, socialized and following a healthy diet will help you overcome your teenage mood changes:)Hope it helped!
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 neurological symptoms pinching burning numbness weakness high pitched sounds in head titching kicking muscle jumping tingling and other sensations and ect my symptom s come and go. my first emg was positive for Peripheral neuropathy lower legs and feet symptoms spread threw body had a second emg was normal even though i still have symptoms in feet lower legs and now threw out my body I also have a lesion on my cervical spine does a emg diagnose multiple sclerosis ### output:	His read your problem, actually peripheral neuropathy is a disorder that occurs when nerves malfunction because they are damaged or destroyed. Causes of peripheral neuropathy-Generalized diseases nerve damage caused by diabetes is one of the most common forms of neuropathy. The risk of neuropathy increases for people whore over weight have high blood pressure are over the age of 40 have diabetes other chronic causes airline disorderHypothyroidismDeficiencies of vitamins E, B1,B6, and B12, which are essential to nerve health NAD functioning. InjuryPhysical trauma is the most common cause of injury to the nerves. Alcholhol and toxins infections and autoimmune disorders. MedicationsTreatment options for peripheral neuropathy again medicationsAcetaminophen and non-steroidal anti-inflammatory Chat Doctor. Medical treatment-TENSErgonomic casts or splints. And you have multiple sclerosis and there is no cure for multiple sclerosis. For the further treatment or investigation consult the orthopedic or euro.
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, I have some problem relating to my behavior/ personality or I don t know exactly what you call it. I cant be able to concentrate on my work as lot of destruction keeps on hitting my mind away from the work. I discussed about it with my friend earlier through online chat, she asked to consult a female psychiatrist as my problem is related to females. So please advice me a doctor to look after my problem and it shouldn t be expensive as I don t possess lot of money. ### output:	Degree understand your concerns went through your details. I suggest you not to worry much. You have not mentioned your age. Concentration problems do arise to people at every stage, but it is more present with young adults. You are supposed to refer to concentration and attention as two. Attention span for any adult is maximum 30 minutes. Sometimes, a person can be attentive to an interesting thing for more than 30 minutes, such as movies or games. Concentration is attention plus understanding. For this too, span of below 30 minutes. If you are able to make your studies interesting and based on variable principle, your concentration level can be increased. Concentration comes only when you are interested in what you do. So please be passionate towards what you are doing or do only those things which you are interested in. It is also possible to improve your concentration level with the help of yoga, meditation and breathing exercises. Psychotherapy techniques should suit your requirement. If you require more of my help in this aspect, Please post a direct question to me in this URL. http://goo.gl/aYW2pR. 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.
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 a 20 year old female - 5 7 , 120lbs. For several years now, whenever I stand up from a sitting or, especially, a reclined position, my vision goes dark, I feel light headed, and my arms and legs feel very heavy. It used to be that I could always just go about my business and after a few seconds I d feel totally better. I went to the doctor about this because, for a month or so about 2 years ago, I was randomly passing out during these spells. They did an ultrasound on my heart and gave me medication to raise my blood pressure. The fainting then stopped and the condition went back to my normal level. But over the last 3 weeks or so, when I go from lying down to standing up, my vision goes almost totally black and I feel like I can barely move my arms or legs because they re so heavy. I feel so faint these days, that I d say about 60% of the time (lying down - standing) I wind up falling to my knees and putting my head on the ground so that I don t pass out. After a few (15-45) seconds, I m able to stand up and carry on. What could be causing this? ### output:	Thank you for asking Chat Doctor. My name is Chat Doctor. Well this might be due to postural hypotension...I would like to know that either you are on dieting or not. Make a habit of taking proper diet timely so that your blood pressure and blood glucose level could be of optimal level. Then wait for at least 2 weeks if this problem remains continued then visit medical consultant to find out the cause of this postural hypotensionHope this may help you. Let me know if anything is not clear. 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 Doctor, My tailbone has been killing me for the past few months. The pain is a heavy - pressure kind of pain. My MD had X-rays taken, this showed nothing. I saw him the other day and told him I still have this pain. He said he is not sure what else he can do for me other than use a donut when sitting. I sit at home on a nice soft leather recliner, my tailbone still kills me. I end up leaning on my side when I sit, but when I get up, the pressure/pain is terrible. I notice the pain/pressure even when I walk. Hurts when I sleep, especially turning over. I do want to mention that I had a colon resection back in 2005. I had a tumor in my rectum. The surgeon could feel my tumor, that is how low it was. I am worried I may have another tumor. PLease give me some advise what I need to do. THANK YOU FOR YOUR TIME! ### output:	Hello! I read your question and understand your concern. In my opinion the pain you have may be related to a sacral bone problem. I would like to know if you have fever or problems with the stools. These problems may be caused by a tumor infiltration the sacral and cochineal bones, by an infection of this region like an abscess or osteomyelitis, or by irritated nerves of the region from radiotherapy. Your past medical history is very concerning. You didn't mention radio or chemotherapy. So I would recommend a good physical by your GP, a full blood work for infection and a CT scan or MRI of the pelvic region to exclude these causes. Hope to have been helpful! 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 a sore on my gums the occasionally swells with blood and puss. It is above the farthest molar on the left side. Above that where the gum and the cheek meet there seems to be a solid mass that is white underneath the skin. My neck and back have been stiff and sore with a lump underneath the muscle just where my neck meets the shoulder. Something does not seem right. I went to the ER a month ago and was diagnosed as having a salivary gland stone. I went to an ENT who did a procedure with wires to open up the gland, but there was no stone. The mass that I was trying to explain is still there. Is this very serious? ### output:	Hello, I can understand your concern. The swelling you are describing can be a result of abscess formed due to infection of the lat molar tooth. As it is on the gum just above the tooth, this can be the possibility. In that case, if you go to the dentist, he/she can examine your oral cavity for such infectious tooth and can Chat Doctor. Other possibility can be presence of cyst or tumor. In that case, the swelling or part of it needs to be excised and sent to the laboratory for the diagnosis of the tumor or cyst. This process is called biopsy. It also evaluates whether the cells of the swelling are harmless (benign) or cancerous (malignant). You should consult an oral & maxillofacial surgeon for such procedure. Treatment can be advised after the results of biopsy come. I hope this information helps you. Thank you for choosing Chat Doctor. I wish you recover soon. Best,
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,My Son is three months old, he s suffering from acute gastric and flatulence.. He was diagnosed with jaundice when he was 6 days old the level of bilirubin was 11.7, it took long 6-7 weeks to cure jaundice... After a few days he started having stomach aches n very acute gastric problem. He was first advised normal/general Colicaid n Gripe water... But the problem was severe that he was immediately prescribed Espumisan, Neopeptine and Drotin(SOS) it s been over a month with no relief... He farts like adults n that too with too much difficulty his stomach swells like a big HARD ball. Recently we got his stool test done the report is - PUS 5-6 with presence of mucus and Reaction RH is 6.3 also RBC - 1-2. Please Advice Regards Sourav Moudgil ### output:	Hi... Thank you for consulting in Chat Doctor. This is called evening colic and is quite common in this age group. This happens when the baby sucks at the breast very fast and in eagerness to Chat Doctor. Unless the air comes out like burping or flatus this discomfort will be there and next time check if she is sucking too fast and gulping in air too. You will be more convinced. Usually I don't advice any medicines for this as they give only temporary relief. Hope my answer was helpful for you. I am happy to help any time. Further clarifications and consultations on Chat Doctor are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid 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: kindly check this semen report and give comments. Appearance: Creamy White Consistency: Thin Volume: 2.5ml PH: 8 SPERM MOTILITY (100%) (100 spermatozoa) a) Rapid Progression: 55% b) Slow Progression: 15% c) Non-Progressive Motility: 10% d) Immotile: - Agglutination: - Count/ml: 105 million MORPHOLOGY (%) Normal 60% Abnormal 40% Head Defects: 15% Tail Defects: 10% Neck & Mid Piece Defects: 10% Cytoplasmic Droplets: 3% Headless Pinhead : 2% Pus Cells: 0-1 Red Blood cells: 2-3 Epithelial Cells: 0-1 Miscellaneous: Nil Duration of Abstinence: 15 Days Liquefaction Time: 30 min I am 30 year old, married one year before but still not conceiving . ### output:	Hello, welcome to Chat Doctor, Firstly, the physical examination of the sperm is quite ok. Count is within normal limit (normal is >20 million/ml as per WHO 2009). Motility of the sperm is also within normal limit (Normal is >40 % as per WHO 2009). Normal sperm morphology is also satisfactory (normal is >04% as per WHO2009). Others are within normal limit. So, you are totally fertile. Your wife needs to be investigated appropriately. 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: A few weeks ago, my new boyfriend and I started a sexual relationship. The first few times, I noticed that he had very quick orgasms. I thought nothing of it until the last few times that we have done the deed, I noticed that he was not aware that he had reached an orgasm. He only noticed when we went to change positions that the condom was full. This alarmed me because the discharge seemed to be rather watery and he did not have any affects of a man who was having an orgasm (ie. no increase in speed, movements or moans). I understand that a man can have precum prior to an orgasm but this was way too much to be precum and it was also a milky white color. The discharge could easily pass as orgasmic fluid but somehow I think that there may be something wrong. What could this be? Am I over reacting? ### output:	Degree understand your concerns went through your description. I suggest you not to worry much. I think you are overreacting. It is your boyfriend, who is supposed to be worried. He is having orgasm. He is ejecting. Young people do have watery semen for more efficacy. His pleasure is supposed to be there but not as you see in sex movies and blue films. Actually those actors are over acting. Some people enjoy orgasm in silence and some hiss and some get tight and some moan. Everything cannot happen together and the way of reaction changes almost every time. Therefore, you are supposed to be over reacting. You and your boyfriend might need psychological counseling., I am more than happy to provide telephone psychological counseling through Chat Doctor. Contact me through customer care, www.ChatDoctor .com. 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: I have recently gone through a general check up program whrein in the ultrasound it showed a 1.6 cm cyst in the right kidney . The consulting doctor says nothing to worry. Meanwhile I have been having mild backache for several days. The pain is also being experienced in the left side of my lower abdomen. My age is 59, female and have gone throught total hysterectomy few yrs back.. Kindly give me insight for the cause of thsi pain. ### output:	Hello welcome to ChatDoctorRenal cysts is a fluid collection in the kidney. The Majority of renal cysts are benign and can be monitored without any treatment. However, some are malignant and have to be removed by surgery. Simple renal cysts are found frequently in the elderly. The renal cysts have been classified into five categories by Bosniak Category I: benign simple cyst without septa, calcification or solid component. Category II:Benign cyst with few thin septa and contain fine clarifications Category IIF: Well marginated with a number of thin septa with thick nodular calcification and >3cms in size. Category III: Indeterminate cystic masses with thick septa with enhancement. Category IV: Malignant cystic masses with thick septa with enhancement and irregular marginsSometimes a CT scan is needed to distinguish between simple and malignant certain in the cyst may be due to hemorrhage or abscess with in the cyst, or it enlarges to compress other organs. The pain you might be having may be due to some other cause as it is on left side too or due to Tight your urine checked. Hope I have answered all your queries. Wish 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: I m 19 years old and I went to the hospital 2 weeks ago for inflamed ribs, the medication has worn off and I still have inflamed ribs, the medication I took was Celecoxib, and my inflamed ribs appear to be getting worse. Anyways I took a shower and noticed I get light headed and sore all over my back and chest when I stand for to long, I also noticed my left upper body was red, Spot like when I stood for 20 minutes at a time, Can this be poor circulation because I am skinny (130 pounds 6 feet tall) or can this have to do with my inflamed ribs or a heart problem? Another issue is when I sit for to long my inner legs start to hurt and my feet become numb Oh and before I forget my inflamed ribs are worse on my left side. Thank you to anyone who helps. ### output:	Thanks for your question on Chat Doctor. I can understand your concern. By your history and description, possibility of vitamin B12, calcium and vitamin D3 deficiency is more. Chest and back soreness is commonly seen with calcium and vitamin D3 deficiency. Numbness in lower limbs is commonly seen with vitamin B12 deficiency. So get done blood levels of vitamin B12, calcium and vitamin D3 and if deficiency then you will need supplements. Also avoid movements causing pain. Avoid bad postures in sleep. Avoid heavyweight lifting and strenuous exercise. Apply warm water pad on affected areas of chest and back. Don't worry, you will be alright with all these. Hope I have solved your query. I will be happy to help you further. 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: Had an ekg with result of septal infarct, age undetermined and normal sinus rhythm. This was done because I have been having dizzy spells , often with constricted pupils and have had a chronic cough for two months. They took blood and did chest xray tlday as well. Have unexplained rash on trunk. Last biopsy at derm showed granulare aneuloma (sp). Have follow up derm next week as rashes have multiplied. Doc referred me to neurology with an mri, pulmonology a d cardiology. A little scary. What are they looking for? Possible lung disease? Had pneumonia this summer which turned out to be difficult to diagnose. ### output:	Thanks for your question on Chat Doctor. I can understand your concern. In my opinion, they are looking for multiple organ involving disease like connective tissue disease (CTD). CTD s can involve lungs, heart, skin, brain etc. In lung involvement, CTD can cause fibrosis, bronchitis, pneumonia etc. So your chronic cough can be due to any of the above-mentioned lung pathology. So better to consult pulmonologist and get done 1. Clinical examination of respiratory system 2. Chest x-ray and CT thorax to rule out fibrosis and pneumonia. 3. PUT (Pulmonary Function Test) for the diagnosis of bronchitis. So better to first diagnose yourself and then start appropriate treatment. You may need antibiotics, antihistamines, inhaled bronchodilators and inhaled corticosteroid (ICS). 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: Hi my name is Mariana. I m taking fentanyl patch 50 mcg. I have been using it for like 2 months. I think this is giving me nausea and constipation . I am taking xeloda for my cancer treatment 2 weeks on and one week off the xeloda. On the week I m off i still think its the patch that makes me feel nausea and vomit . Cause that week I m off the chemo I still vomit so the only thing I m using is the fentanyl patch. I was using the 75 mcg but then 1 week ago I lowered it to 50 because I m afraid to just stop it once and I will feel the withdrawals. How can I get off the fentanyl patcChatDoctorpletely. Oh the patch I used it for my aching back and shoulders. I took Ondansetron 8 mg but still don t help. So I stopped taking it cause when I did I actually vomited as well. So I stopped taking it. I have the feeling the patch is causing the nausea but I m afraid of the withdrawals symptoms if I suddenly stop. What can I do, I want get off the patch. ### output:	Dear, I have not understood what type of malignancy you are suffering from yes these morphine analogues in the form of fentanyl patch does give the feeling of nausea and vomiting in a very sensitive patient. You can get rid of it by reducing the dose and substituting it with tramadol under the advice of your physician. If your malignancy is under control so must be your body pain as we. In such case you can do away with fentanyl and there will be no with Chat Doctor. Truly,
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 name is Harrison Hughes and I am researching breast cancer for a school project and was wondering if you could answer some questions? What are the signs of breast cancer? What should you do if you find a lump? Can wearing bra cause breast cancer? Can Benign Cysts Become Cancerous? Can you Inherit Breast Cancer? Is it as common for guy to get breast cancer as a girl? Can physical activity reduce the risk of breast cancer? Can a healthy diet help to prevent breast cancer? Does smoking cause breast cancer? Can drinking alcohol increase the risk of breast cancer? ### output:	HIT hank for asking to ChatDoctorI appreciate your concern here are the answers of your questions 1) while comparing with the normal breast, the normal breast looks more pendulous than the malignant one, on palpation one can feel the hard lump inside the breast, untreated case more prone to fungal infection, loss of weight.2) If you find the lump look for mobility if this is freely moves then no need to worry, still mammogram, CT scan, biopsy are must.3) Wearing the bra does not cause the cancer. 4) NO if this benign lesion then this can not turn into malignancy. 5) The breast malignancy is not always inherit ant. 5) Being a female you could get the breast cancer this is not true, but of course the incidence increased. 6) If you are physically active then the chances of these reduces greatly. 7) The balance and healthy diet makes the difference. 8) the chances of breast cancer in smokers is higher than the non-smokers, and the same is true for alcohol, hope this information helps you have nice day.
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 been having constant lower back pain for over 6mnths or more. I have pain in the top of my buttocks and comes around to the top of my thighs, pain also goes down my left leg but not all the time. Looking at my lower back it looks like their is like a hump their and very tender to touch. I have been told that I have O/A in my facet Joints. I have also been to a chiropractor and was told that I have strained the sacrioliac Joints. I didnt get any relief from having 6 sessions. I am unable to bend down, and I am struggling to walk properly and having a problem with getting in and out of the car, I have to lift my right leg up to get into the seat properly which is very painful.My GP has now referred me to see a Specialist, time frame to see anybody is 2mths. This pain is getting me down considerably. As soon as I get up in the morning Im in so much discomfort. I have been using cold and ice packs to see if it will help, and I am taking coedine. Im getting no relief from either. I am lucky that I have a very high pain threshold. But enough is enough. Have you got any other solutions that could help me. ### output:	HIT hank for asking to ChatDoctorPhysiotherapy is the best option for this along with the NAIAD and the best choice is Tab. Diclofenac sustain release 50 mg tab, twice in day with Tab. Acetaminophen three times in day, Steroid gives very good result, but you did not mention your age and gender here, otherwise I could have suggested it according to your age and gender, hope this information would help you, have nice day.
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 plz could you help me, my husband is experiencing some difficulty with ejaculation , he had testicular cancer back in 2007 an only has 1 testicle now, but as he comes to climax he says it feels like his sperms hitting a brick wall, this makes him very light headed an sick, its affecting our sex life as is drive is no where near how it used to be which was high, at first i thought it was me and he d been playing away from home and got an sti but now i now its becoming a problem, he s never had this problem before this is a recent problem is there anything he can take to help boost is sex life an help with the ejaculation many thanks michelle ### output:	Hi... Thanks for your query. Can you tell me, whether your husband is able to achieve adequate erection for a successful vaginal penetration? How long does it usually takes before he ejaculates? Is he currently on any medications? Do you both as couple engage in foreplay before actual intercourse & what form? Based on information you provided, I can conclude that, due to some yet untold problem or just by chance, your husband might have had 1-2 instances of erectile failure or premature ejaculation prior to reaching climax/orgasm. These instances are fairly normal, are common & can happen with any couple. But because of his status of a testicular cancer survivor; these instances might have caused stress/pressure on him with subsequent assumption of spectator role where rather than enjoying sex; he is unconsciously more preoccupied with how he is performing etc. & hence getting these symptoms. You (both as couple) should get yourself evaluated by a Urologist followed by a Psychiatrist for management of this issue. 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: I am 29 years old.I had hand foot and mouth disease back in March but appear to have it again. I had a fever of 40 and puss on my tonsils when I went to the docs a few days ago but since seeing him I have developed the horrible ulcer things that feel like I have splinters on my hands and feet. I also have a red rash over my legs but this is not prickly. Do you think this is hand, foot and mouth or something else. I have had a cut on my hand which is very fiery looking which was there before the spots appeared, could I have a different infection? ### output:	Hello dear, Thank you for your contact to Chat Doctor. I read and understand your concern. I am Chat Doctor answering your concern. Hand foot and mouth disease is caused by the virus. It is usually a being infection. It usually does not cause any pus filled infections. Secondary bacterial infections usually occurs on the infection site of hand foot and mouth disease. I think you are having a secondary bacterial infection that is why pus is collected. In other case you may have some other bacterial infections which occurs directly because of the bacterial attack. I advise you should do culture and sensitivity from the pus arises. It will guide us regarding possible infections. Accordingly, we can use antibiotics to treat the infections effectively. Hygiene maintenance is very important as this can be equally important in treating infections.Handwashing is also a good tool good handwashing will never allow any infection to occur. I will be happy to answer your further concern on bit.ly/ Chat Doctor. Thank you, ChatDoctorInfectious diseases specialist, ChatDoctor.
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 is 69 and in the last year has had pancreatitus, congestive heart failure, was hospitalized and lost 50 pounds in a little over a month and cant eat much now even after a year and cant gain any weight. The doctors are suspecting something going on in the lungs because he is a smoker but the cardiologist yesterday said he his heart is compensating but is functioning at 15 percent. He is anemic and has had blood infusions twice monthly. He is on oxygen full time now but has no energy. Its a huge effort for him even get to a doctors appointment. At what point do you stop running to the doctor and just get hospitalized to get help? He is getting weaker and weaker as last January his heart was functioning at 40 percent. Just need to know what is the best thing to do at this point. Thank you.. ### output:	Hello, Firstly, I don't have details of the patients to give an Overall opinion. Still, anemia should be corrected S early as possible with finding the cause like serum iron studies, it B12 and folic acid levels, stool for occult blood. Anemia will exaggerate heart failure, and it can cause heart failure even in normal heart individuals. Secondly, he should receive treatment like antiplatelet like Aspirin clopidogrel, statins like Atorvastatin beta blockers like metoprolol, ace inhibitor like April and spironolactone and diuretics like horsehide etc. He should be assessed if he is a candidate for CRTD device. Fluid and salt restriction, chest physiotherapy and yoga. Hope this helps you and get back if you have any doubts.
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 20 years and 6 weeks pregnant with my second baby i had a operation when i was 14 for PUJ on the left kidney it was 2 blood vessels crossed over after i had key hole surgery i was fine for about a year then the pain slowley came back and when i fell pregnant with my first baby i had pain the whole way through pregnancy then when i had him the pain eased of but i would get the pain once a month i seen the specialist at the hospital and they said they wasnt worrid about it because the pain wasnt as reacuring as befor so it couldnt be bad i was due to see my doctor about 2 months from now but now i have fell pregnant again im about 6 weeks and i am having the pain every day again do you think i could have ther same thing again (PUJ) and if i have will i have to put up withe the paion the whole way through pregnancy and if so will they opperait again after ? ### output:	Hi, Vessels crossing the junction is one of the frequent causes of POJO. If treated properly, is unlikely to recur. Pregnancy itself is a strain condition to the ureters. The gravid uterus compresses the pelvic inlet and the ureters. This can lead to urinary retention. This requires no active treatment except changing the position sometimes. Try lying in left lateral decubitus position. If you are very afraid, you can get a USG of the kidneys. But don't be afraid if there is HY Chat Doctor. (Because the size of kidneys will not become completely normal even after surgery). After your delivery, you can get a DTPA genogram to confirm unobstructed
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 Angelman Syndorme She has been taking Senokot liquid via her g-tube since she was aprox 3-4 years old. the senokot brand liquid does not sell anymore in the US I have been ordering it from Canada/ I bought a generic brand . can t afford senokot anymore. It didn t work as well. I used the bottle up and havent recieved my other shipment yet. She get s it every morning. I have no dose for tomorrow. But she has not had a bowel movement since saturday evening. Is there something else that may stimulate her to go? She also takes meralax to soften her stool. I tapered her senna dose I was slowly trying to try to get her off of it I went from 10ml to 6.8ml. I think her body needs a stimulant her stool should be soft she just can t pass it. trying to get her body working on it s own again. I don t know if it will but I d like to try. she is 22yrs old now. ### output:	Hello there! Thank you for asking. I want to warn you to not manipulate the doses of your daughter. If you think something can be done about that consult her doctor. Don't try to be smart enough to do that your self. You will bring more harm than good. Let this thing be professionals decision to do. Trade names don't matter. Until and Unless the generic brands are same. You can ask the doctor before taking medicines. Remember it's not some experiment. And doing anything without opinion would be something to repent on for the rest of life. Stay in touch with her doctor and keep serving her. I know you mean well. Take disregards 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: Currently i am in MBA 2nd semester. Before this i was working with an organization from where i have to go my regional headquarter of my company . i use to go many times in month.last time when i was discussing with my friend about work. i forget the place name where the head office of company is located. though during that period , i was having great picture in my mind how to go there or through which path i used to go there. but couldnt remember the place name.it happens many times with me. many times i forget my friends name but i do remember the face of my friends but couldnt able to call back my friends name. such periods have duration of 1-10 min. not more than this. then automatically name comes in mind. i have also low concentration and weak memory too.please tell me what kind of this problem is i have no idea bout this. ### output:	Degree understand your concerns went through your details. I suggest you not to worry much. There is nothing to worry about such type of forgetting. This is not memory loss. Such a situation is normally called "tip of tongue phenomenon". The tip-of-the-tongue phenomenon (TOT), sometimes called pressure VU, is the failure to retrieve a word from memory, combined with partial recall and the feeling that retrieval is imminent. The causes of Tots are largely unknown, but numerous explanations have been offered, but they are beyond discussion usefulness here. You just have nothing to worry about your condition and ignore it. If you require more of my help in this aspect, Please post a direct question to me in this website. Make sure that you include every minute details possible. I shall prescribe some psychotherapy techniques which should help you cure your condition further. 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: my son is 5 years old and has swollen lymphnodes in is neck and all are less then a centimeter and are soft and movable. My doctor has asked to get a chest xray and really has no definete reason or cause for them. He has told me that it should be nothing to worry about but i cannot help but worry but i do trust what my doctor says! My son does not complain of any pain and is a healthy spunky 5 year old boy, he does need some dental work done just waiting to get in to see dentist so i just wondered could this maybe have somthing to do with these swollen lymphnodes or just any answers from you at all, thank you ### output:	Hello. Thanks for asking on Chat Doctor. I am a pathologist and deal with swollen lymph nodes in my patients daily. From your description it seems that the lymph nodes are small less than 1 cm and soft and mobile. Usually most common causes are reactive lymphadenitis. In this case any infection in the area of Chat Doctor. Usually it is not of any concern and subsides on its own. Causes could be as simple as dental caries, tonsillitis or pharyngitis, ear infections etc. Sometimes cause of reactive lymphadenitis is not found. Other causes could be a serious chest infection which is ruled out by x Ray in your case. Other rare causes could be a lymphoma or cancer in which lymph nodes are larger and harder and not mobile. All these diagnoses can be easily made with a fine needle aspiration cytology test in which a pathologist inserts a needle into the swelling and obtains few cells to be stained and seen under a microscope. However child
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 son is 8 months old. He has suffered 2 times. His nose get blocked and during motherfeed, he felt very difficulty. Sounds comes from his nose and some times he breathed by opening his mouth. my local doctor prescribed during winter season Claritek and Myteka Sachet alont with some cough syrup. He sid that his chest was infected. With 5 days treatment, he got better but Myteka was given about 12 days. After 2 months, he suffered with serious flu . Doctor again recommended same medicine. Claritek dropper for 5 days, Myteka for 6 weeks and one alergic syrup. This time he said that chect is not infected but could be if we dont give claritek. Now he has relief but Myteka is being given. My question is what type of disese he has after few months. I have removed all carpets from my home to avoid dust diseases. Is he has some type of alergy that causes above syptoms after few months again and again. I am confident that he dont have asthma . ### output:	Hi. This presentation can mean an allergic rhinitis with extrinsic asthma, which is generally associated with a secondary viral or bacterial infection casing recurrence He is on right treatment and this is what is done generally, as he is very young, with age, his immunity will also increase and by 12 years I expect him to be fine if it is an asthma. Continue the steps your taking now to avoid dust, etc. and I hope he feeds well. Take him for his vaccinations and regular check-ups. Avoid exposure to cold climate and keep him clad when he is taken out preventing dust, cold, etc. 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, for the last 5 months I have had 3 lumps in my neck, pea size, they do not hurt, but recently my neck aches where they are, I have been to the doctors a few times, my blood test was fine, and was told i had no infections, and to keep an eye on the lumps, I recently found a very small lump under my chin, my body is so tired i just want to lie down all day and do nothing, On a few occasions my right leg goes totally numb and im unable to walk it last a few minutes, I get bad headaches including migraines. My doctor has now put me forward to see a hematologist, in the day if i do anything little, like standing up and washing the dishes i sweat so much,this has been happening for ages now. I am getting very bad lower back pains, and stomach aches the last few weeks, as of yesterday I have felt quite poorly, and last night my neck felt swollen and realised i now have a swollen left tonsil, which is slightly white there is no pain whatsoever. Sorry for going on so long just wanted to put across everything ### output:	Hi, dairy have gone through your question. I can understand your concern. You may have some enlarged lymph node in neck. It can be due to enlarge lymph node. Lymph node enlargement may be due to reactive hyperplasia, tuberculosis or lymphoma. You should go for biopsy of that lump. It will give you exact diagnosis. Then you should take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using Chat Doctor. Wish you a very 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: I have severe panic disorder in which i feel like i am having a heart attack with feeling of doom. i have had this yeder for more than seven years. I was taking citrolopram for about five years and decided to stop in July. Since then, my panic attacks have increased immensely. I started taking webutrin but only lasted days on that due to the side effects. I am now taking citrolopram mg again for the past six weeks and have tremors and chest pain when i wake up every morning. It then turns into a major panic attack. Then i find that i have to take klonopin to take the edge away. I want to change to a different med than celexa and have heard that klonopin is the answer. What do you suggest? ### output:	Hi there, thanks for asking. You are right about Klonopin. In the first few months of start or restart of the pharmacotherapy, Klonopin or another medication from its class should be added to the treatment. Citalopram is a good medication for treating the panic attacks, and you may use another medication from its class like Escitalopram, paroxetine or even fluoxetine instead of citalopram. I understand that citalopram may have some side effects on you, or even you may have become bored about using the medication. Wellbutrin is not an appropriate medication for panic disorder and can increase the attacks. I should say that management of panic disorder includes the combination of medication and talk sessions. When you talk in free association about the issues currently happening around you with a psychotherapist and get gradually some feedback, you will be able to discontinue gradually the medication without any problem. I wish you the best 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: Dea doctor, i experience diaphragm spasms, or that is what i think I have reading from the internet. It occurs at night and is a debilitating pain right under the bust area, almost like a knife being poked out from under the skin. When this happens, breathing is difficult, lying down is utterly painful, the only position confortable is sitting cross legged on grond and having my head tilted forward, arms below head, to relieve the pain from the spasms. They occur mainly at night and the pain continues throughout night, and is debilitating. It may be connected to stress but am unsure. I am desperate to find a cure or way to stop these diaghram spasma, is there a specialist i should visit? I live in Pasadena, CA. Thnak you. Isabelle ### output:	Diaphragm spasms are usually more like hiccups, although bad hiccups can also be quite painful. It sounds like you are having esophageal spasms, which can be very painful. Either way, you need to be evaluated for both as treatment may vary. You might also have reflux esophagitis which can be related to aspiration of stomach acid. This can cause laryngeal spasm which can also result in shortness of breath and pain. Your best option is to start with a gastroenterologist (GI specialist). They can do an endoscopy to take a direct look into your esophagus or other tests to check the pressures and see there are muscle spasms or inflammation. Stress could certainly aggravate these conditions, but it would be important to know exactly what is causing them so that the correct treatment is started. Hope this 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: For some time now I have been experiencing wet underwear and discoloring on the seat of my underwear. Been tested for stds and everything came back negative. Thought it was my ph balance so I used the vaginal gel and now taking the pills. Symptoms still are happening. I think the cause of the wet panties is from slowing leaking urine. Do you think you can help me out ? ### output:	Dear patient, If you think the wet panties have a urinary tract origin instead of vaginal mucus, than I would recommend you to visit a Urologist. There are different types of urinary incontinence, which a specialist will be able to determine the right one after a thorough medical examination. It can be a:- Neurogenic bladder. Small amounts of urine loss both day and night. It can be treated with Chat Doctor. - Fistula. Continues loss of urine day and night. Treated with surgery. And then there are some conditions which I don't think apply to your case such as Hypertonic bladder. Regarding the discoloration, if STDs are not the cause, I would like to know more about your menstrual cycle. Often, what we call estrogenic cycles are the cause of irregular menstruation associated by intermittent uterine bleeding that end up as spots in your underwear. In this case, progesterone contraceptives are the recommended treatment. In case of a desired pregnancy, please consult an ob/gun. You will need to stabilize your cycle or help the ovulation, and the spotting will disappear during pregnancy. I hope I have helped you dear! Wish you health, Manoku ENI, M.D.
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 22. About 90 lbs. 5 1 . I have for awhile now have gotten chest pains on my left side. They come and go throughout the day lasting only a few seconds.I feel short of breath occasionally. Never cough (unless I have a cold). Sometimes my heart beats fast and I get dizzy when I stand I have had 4 migranes within the last month always with aura. I have smoked since I was about 15. Average 1/2 pack a day. I recently had EKG, Chest x-ray, blood work. All came back normal. But I am worried I have a heart disease or lung cancer. These are the only symptoms. I have had three children (2011, 2012, 2014) all healthy normal pregnancies. No other known health problems. Have generalized anxiety and bi-polar. Should I ask my dr about lung cancer because I smoke? ### output:	Hello dear, thanks for your question on Chat Doctor. In my opinion you should consult pulmonologist and get done PFT (pulmonary function test) to rule out bronchitis as it is common in smokers and cause similar symptoms. So get done PFT. It will also tell you about severity of the disease. And treatment is based on severity only. You may need inhaled bronchodilators too. And quit smoking as soon as possible as it will only harm you. If PFT is normal than mostly you are having anxiety only, because other investigations (blood report, chest x-ray and ECG) are normal. So better to avoid stress and anxiety. Be relax and calm. Consult psychiatrist and try to discuss all your symptoms.
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 is in her 40 s and is experiencing chronic pain in the lower back and pelvic area She does have fibroids,but according to her Dr it should not be causing this amount of pain. She had her gall bladder removed last year and has been diagnosed with stage 2 fibrosis of the liver. She has been to the doctor and had tests run but they did not find anything except the fibroids,and also an elevated white blood cell count,which as of today is unexplained. She also had quite a few polyps removed about 4 years ago during a Colonoscopy and was told they were the type that can potentially become cancerous. This has been going on for over 6 weeks and is getting worse. Any suggestions of a specialist that may be able to help? Thank you in advance for your response, YYYY@YYYY ### output:	Hello, At her age of 40, likely cause of pain may be disc degeneration or mechanical back pain due to the instability of the lower spine. She had a history of polyp in the colon which may be cancerous than we need to rule out vertebral metastasis. I would advise an x-ray of the lumbosacral spine anteroposterior and lateral views to rule out bony abnormalities. MRI of the lumbosacral spine is needed which is very sensitive and specific for the diagnosis of spine pathology. Both can be done at the radiology center nearby you. Meanwhile, start tablet Attract twice a day for pain relief. Take rest on the hard bed and avoid forward bending and weightlifting. Visit an orthopedic spine specialist with the report is needed. 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: Hello. I am interested in fertility drug without a lot of timely testing. We are both lawyers in a small town and we do not want anyone to know . I am 45 years old. I had two healthy pregnancies (ages 25 and 21). I miscarried in 2012. I have not conceived since that time. My SO has never had children (except for the miscarriage). Is there a fertilty drug that is safe and my help me conceive at my age? ### output:	Hallow Lawyer, There are many medicines which help in assisting the conception. However, each medicine is fault specific. Problems in fertility could be due to either fault in man or woman. The fault in man could be low or unhealthy sperms. Depending up on the fault, the treatment changes. If there are any transport problems, the treatment differs. In woman, the faults can be grossly bifurcated into non formation or release of eggs, unfavorable uterine environment and block in the genital tract not allowing the sperms to meet the egg. Each fault needs a specific treatment. There is no blanket treatment for infertility without knowing the cause behind it. You cannot defend your client if you do not know the offense. It is just like that. Please take help of a Gynecologist to pinpoint the cause of infertility. For the diagnosis, you will have to undergo a battery of investigations. Once the fault is detected, the case can be managed effectively and scientifically. Since you have conceived previously, the chances are good however, your age is against the good chances. I am sorry, I could not answer to your expectations; however, I have answered scientifically and logically. Please take my advice healthily.
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 vitamin b12 level from my blood test is extremely high 1,576.00 What causes that And should I BE concerned. I do have Hashimotos thyroiditis,hepatitis c,hypertension, chronic pain (esp.BACK,NECK ETC.) AND JUST FOUND OUT THAT MY AORTIC VALVE AND MITAL VALVES HAVE MODERATE AND MILD REGURGESTATION. I WAS HOSPTALIZED FOR MENTAL STATUS CHECK AND CONFUSION, WHILE IN ER BECAME COMPLETELY CONFUSED,NEEDING RESTRAINTS (NO MEMORY OF THIS) FOLLOWED BY ACUTE RESPIRATORY FAILURE REQUIRING INTUBATION,NG TUE,THE WORKS BUT THEY PULLED ME THROUGH. MANY TESTS STILL DON T KNOW CAUSE OF RES. FAILURE. HEMOGLOBIN 10,RBC 3.35, HEMATOCRIT 32.9, SATURATION %10 BILIIRUBIN 0.2. MANY OTHERS CAN YOU HELP? ### output:	Thank you for your question. In your case it may be due to hepatitis that high B12 level is showing.However, if your doctor is managing it also your other disease conditions, you need not worry. Your kidney status and functions should also be assessed to be on safe side. Repeat complete blood count and bone marrow examination. Consult a clinical hematologist also. Pappaya is a good fruit for blood disorders so try it every day.
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 pain in my lower back and cramps like on my left thigh some times when i sit i feel better but when i walks or stand for more than one hrs. then again pain in my lower back starts few months ago my MRI ( LUMBOSACRAL SPINE) showed as: Mild diffuse disc bulge with protrusion at L4-L5,Annular bulge at L5-S1,Predominatly Para-Posterio-Central(RT LT) resuling compression over the epidural SAC,Thecal SAC,Exiting nerve roots with maintained spinal canal dimension & neural formation stenosis at L4-S1 suggested mild prolapsed intervertebral disc with polyradiculopathy.Early Lumbar spondylosis changes. As per suggestion of Doctor(MCH.ORTHO) i am taking Zevanuron Capsule once a day since one month but there is little improvement in my lower back pain .I am 33 years old and my weight is 74 Kg and height is 5 2 . Should i continue ZEVANURON CAPSULE only or any other medicine ? Kindly suggest me about root cause of pain in lower back ,medicine ?,precausions etc . ### output:	Hello, I had gone through the case and report and found that this is good medicine for strengthening of nerve. But you need to take calcium also. You must go for one blood test Vitamin D3 and Vitamin B12. If it is low then take Vitamin D3. If pain persist then take some session of physiotherapy and learn some particular yoga for pain relieving. Follow all the instruction and feel better in pain. Hope my answer will be effective for you. 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 am an asthma patient for the last fifty years originated from acute cold for which a tablet was provided to stop cold with asthma to paste on chest At 2 Oclock mid night I wakened up and felt difficulty in breathing but cold had absolutely come down. Then I went to another doctor and he gave me dycristin injection and calcium also. every fortnight i had to do this and then some other medicines were prescribed thus i fell as a regular patient. Now I am eighty three years old before taking this bad tablet I could swim thousan yards to and fro but now I cANNOT WALK A FEW STEPS OR TALK A WHILE , BYTHE TIMEi WHEESE. THANK YOU DOCTOR ### output:	Hi, Asthma is itself an allergic disease due to cold (or dust or pollen or grass etc.) irrespective of the triggering factor. Your asthma actually triggers bronchospasm which leads to your wheezing and breathing difficulty. You can go for pulmonary function tests if not done. Treatment is mainly symptomatic which might require inhalation steroids, beta agonists, anticholinergics as MDI or rota haler as a regular treatment. There are very good medicines like steroids, alpha a Chat Doctor. To decrease the inflammation of bronchi and bronchioles, you might be given oral antihistamines with mast cell stabilizers(montelukast) and steroids (prednisolone) with nebulization and frequently steam inhalation. The best way to cure any allergy is a complete avoidance of allergen or triggering factor. Consult your pulmonologist for further advise.