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The dataset generation failed

Error code:   DatasetGenerationError
Exception:    ArrowInvalid
Message:      JSON parse error: Column(/output) changed from string to number in row 137
Traceback:    Traceback (most recent call last):
                File "/src/services/worker/.venv/lib/python3.9/site-packages/datasets/packaged_modules/json/json.py", line 174, in _generate_tables
                  df = pandas_read_json(f)
                File "/src/services/worker/.venv/lib/python3.9/site-packages/datasets/packaged_modules/json/json.py", line 38, in pandas_read_json
                  return pd.read_json(path_or_buf, **kwargs)
                File "/src/services/worker/.venv/lib/python3.9/site-packages/pandas/io/json/_json.py", line 815, in read_json
                  return json_reader.read()
                File "/src/services/worker/.venv/lib/python3.9/site-packages/pandas/io/json/_json.py", line 1025, in read
                  obj = self._get_object_parser(self.data)
                File "/src/services/worker/.venv/lib/python3.9/site-packages/pandas/io/json/_json.py", line 1051, in _get_object_parser
                  obj = FrameParser(json, **kwargs).parse()
                File "/src/services/worker/.venv/lib/python3.9/site-packages/pandas/io/json/_json.py", line 1187, in parse
                  self._parse()
                File "/src/services/worker/.venv/lib/python3.9/site-packages/pandas/io/json/_json.py", line 1403, in _parse
                  ujson_loads(json, precise_float=self.precise_float), dtype=None
              ValueError: Trailing data
              
              During handling of the above exception, another exception occurred:
              
              Traceback (most recent call last):
                File "/src/services/worker/.venv/lib/python3.9/site-packages/datasets/builder.py", line 1815, in _prepare_split_single
                  for _, table in generator:
                File "/src/services/worker/.venv/lib/python3.9/site-packages/datasets/packaged_modules/json/json.py", line 177, in _generate_tables
                  raise e
                File "/src/services/worker/.venv/lib/python3.9/site-packages/datasets/packaged_modules/json/json.py", line 151, in _generate_tables
                  pa_table = paj.read_json(
                File "pyarrow/_json.pyx", line 308, in pyarrow._json.read_json
                File "pyarrow/error.pxi", line 154, in pyarrow.lib.pyarrow_internal_check_status
                File "pyarrow/error.pxi", line 91, in pyarrow.lib.check_status
              pyarrow.lib.ArrowInvalid: JSON parse error: Column(/output) changed from string to number in row 137
              
              The above exception was the direct cause of the following exception:
              
              Traceback (most recent call last):
                File "/src/services/worker/src/worker/job_runners/config/parquet_and_info.py", line 1456, in compute_config_parquet_and_info_response
                  parquet_operations = convert_to_parquet(builder)
                File "/src/services/worker/src/worker/job_runners/config/parquet_and_info.py", line 1055, in convert_to_parquet
                  builder.download_and_prepare(
                File "/src/services/worker/.venv/lib/python3.9/site-packages/datasets/builder.py", line 894, in download_and_prepare
                  self._download_and_prepare(
                File "/src/services/worker/.venv/lib/python3.9/site-packages/datasets/builder.py", line 970, in _download_and_prepare
                  self._prepare_split(split_generator, **prepare_split_kwargs)
                File "/src/services/worker/.venv/lib/python3.9/site-packages/datasets/builder.py", line 1702, in _prepare_split
                  for job_id, done, content in self._prepare_split_single(
                File "/src/services/worker/.venv/lib/python3.9/site-packages/datasets/builder.py", line 1858, in _prepare_split_single
                  raise DatasetGenerationError("An error occurred while generating the dataset") from e
              datasets.exceptions.DatasetGenerationError: An error occurred while generating the dataset

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instruction string	input string	output string
Answer the following medical question in a clear and concise way.	My 14 mth old was prescribed movicol yesterday, he s got a follow up app next week to maybe change from movicol to something else but I wondered how long he could be on it for as I ve heard a few people say family members/ kids have been on it for years.	Hi... Thank you for consulting in Chat Doctor. I think your kid is having habitual constipation. I have certain questions and suggestions for you. Questions:1. Did your kid pass motion or meconium on day one of life?2. Since how long is the kid constipated?3. Does the kid have any bleeding along with hard stools?4. How much milk does the kid consume per day?5. Does the kid eat fruits and vegetables (fiber diet) appropriately? You can get back with answers at the following link - www.ChatDoctor .com/doctors/ Chat Doctor. Natural methods are the best to relieve constipation.2. Constipation is a risk factor for UTI3. Maximum milk consumption per day should not exceed 300-400ml4. Minimum 3-4 cups of fruits and vegetables to be consumed per day5. Toilet training - that is - sitting in Indian type of lavatory daily at the same time will help a lot. 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.
Answer the following medical question in a clear and concise way.	hello sir im 21, i have moderate acne my dermatologist recommended me to use faceclin gel in the morning and supatret 0.04 in the night is it right to use this medication ? my skin is becoming very dry coz it and i have acne scars im using supatret on them and i cant notice any difference	Hello, Faceclin gel has clindamycin phosphate and nicotinamide as active ingredients. Clindamycin phosphate is an antibiotic with activity against Propionibacterium acres, the acne causing bacteria and is nicotinamide is anti-inflammatory in nature. Support has Retinoid which is a topical retinoid and this regimen is effective for mild moderate acne. If you have more number of inflammatory lesions and pustules, an oral antibiotic like Azithromycin or Doxycycline can also be added. Side effects of Retinoid include burning sensation, redness and Chat Doctor. You can apply a moisturizer to your treatment like Neutrogena oil free moisturizer or Acne moist cream. If there is a lot of irritation or
Answer the following medical question in a clear and concise way.	my penis is bend little bit to left side its not from my childhood but i m having it when i was 10 yr old. please tell me what should i do operation or injection. asnd my penis is not very broad and thick. and i do ve foreskin do i ve to take it out through opeartion or let it be like this.??	Hello, Slightly bend or curved penis is normal and there is no need to worry about it unless you have some pain on your penis. Regarding the size of your penis, you should not worry about it because even a two-inch penis can perform normal sexual functions. If your foreskin is covers your penis head completely, and you cannot move it forward and back with ease, you may need a simple surgery called circumcision. Hope I have answered your question. Let me know if I can assist you further.
Answer the following medical question in a clear and concise way.	hi my son 6 1/2 years old having sever wheezing now ...iam giving him budicort and levolin combination...today morning 10am once 4 pm once but still controlled anything....infact he is suffering a lot..one of our child specialist asked us to give levolin back to back ( 2 levolin at 9pm to controle severity) given but still he is in the same condtion again 11pm budicort and levolin combination given....now also he still not free with his breath that whistling sound able to outsiders..what to do? let me know how much time gap should be there for budicort levolin combination...will it safe for him nubulizing with these medicine...please help me I will be waiting for the answer thanku.	Hi welcome to ChatDoctori am concerned about you child as your son is having wheeze which is not reduced inspire of giving leveling and decor nebulization, I would like to suggest use of oral steroids at the dose of 1 mg/kg body weight and if he is having any fever use of antibiotics such as azithromycin can give along with this leveling zebu;station thrice daily. If not subsided you can give Dublin nebulization(leveling+ipratropium)hope my answer is useful
Answer the following medical question in a clear and concise way.	My granddaughter had Sclerotherapy on a Hemangioma in her upper calf a little more than a year ago and we were told it was 90% effective. Now she has been experiencing numbness in her toes and foot and her Dr is recommending therapy. Does this sound like some possible nerve damage and do you think therapy will help. If the therapy does not help what other options would be available?	Hi and thank you so much for this query. I am so sorry to hear about this numbness. This sounds like a nerve problem. However, the fact that it didn't happen shortly after surgery makes it unlikely to have been destroyed during this procedure. The procedure might have contributed, but it is not sole responsible for this. These are signs of peripheral neuropathy. Therapy and Chat Doctor. I hope this would be the case with her. If there is no improvement, then she would only have to accept the challenge and adopt lifestyle changes to cope with this. I hope you find this helpful. Thank you so much for using our services, and please do feel free to ask for more information if need be. I wish you the best of health.
Answer the following medical question in a clear and concise way.	hi doctor. m 26 yrs old and was diagnosed with PCOS a yr back. i tried loosing weight as that would help me treat PCOS and get pregnant. we have been trying to get pregnant for a yr now but in vain. ive consulted a infertility center now and they are monitoring my cycle closely and we are told to have intercourse during specific day. i want to know how effective is that method? what are my chances of getting pregnant? should i try IUI?	HIT hank for asking to ChatDoctorEven after having PCs, you can be pregnant, for the pregnancy certain very important things are necessary, intercourse at the time of ovulation period, semen should be sufficient in quantity, the count of sperm should be normal (enough), there must be an ovum in fallopian tube, no infection to either partner, if these factor fulfills then there are great chances of having conception, yes you can try GUI, but again the things will remain the same, have good day
Answer the following medical question in a clear and concise way.	Hello sir, my elder sister gets depressed suddenly and starts creating scene. She says she has become alone and has no true friend. I am her brother and she says that I have separated her from our parents. She is persuing her Masters degree presently. We have tried to console her every time she does like this. For some days she becomes normal but again after a few days, she starts getting upset. She even cries in loneliness in her room. It has become very difficult to control her. We can hardly satisfy what she wants. She always blames me of ruining her life which is not at all true. This is not a new problem. I have seen her doing all these from my very childhood. Any help would be appreciated	Dear brother, The phenomenon of displaying these sorts of mood swings and blaming you for the loneliness and sufferings are the classic symptoms of "SIBLING RIVALRY" which is emanating from her inner mind. As a matter of fact, the elder offspring gets a sort of insecurity feeling, when the second one is taken birth since all attention is diverted towards the newborn which is beyond the comprehension of the firstborn. In this context, the child(your sister) construed that she was being avoided by her parents on your arrival, which hurts her in her inner mind. The inner mind of the first child is not so developed at that stage and is not expected to reason or rationalize the core fact. This could have been avoided, had her been given enough attention, care and a reassurance of the unconditional love of her parents in the midst of all your birth and growth. Unknowingly, she displaces her anger towards you which was originally towards the innocent parents. The elder sister, all through her growtChatDoctorpares the love, care, attention, things, events etc. which you enjoy that of her and confirms her conviction in her inner world. These are all the unconscious process started from her childhood since your birth. The lingering thoughts emanated from the harbored emotions are the causes mood swings. Whatever happened has happened. Need not worry. Everything will become alright. Take her to a Psychologist for intervention and for the mood swings, a Psychiatrist can effectively prescribe some medication for a short duration. The psychological counselling and the unconditional family support will invariably help her mind coming in terms with the reality, and she can lead a peaceful life. In case you need any further clarification, please do check if you can contact me directly. I am from Erode, Tamil Nadu. Best of buckwheat days ahead. Chat Doctor.
Answer the following medical question in a clear and concise way.	Hey about 2 weeks ago I noticed my tailbone was feeling a little bit sore but it is only wen I bend slightly backwards and sometimes wen I bend forwards that I can feel it I just thought it may have been something I done but it still hasnt gotten any better I am a bit worried something might be wrong	Hello. As per your info, this condition which you have is called coccydynia which simply means painful tail bone. This condition can become chronic if proper medication and precautions are not taken. Firstly you should always use padding around that area while sitting down. Avoid any form of injury or trauma to the area by continuous irritation of that area. Avoid sitting down in one position of too long. Consult with your physician who can prescribe you anti-inflammatory Chat Doctor. The form on treatment depends on the status and severity of the underlying damage to the bone based on MRI report. Hope this helps. Regards.
Answer the following medical question in a clear and concise way.	I have a bump on my foot which has been there for a while. My doctor said that it may be a cysts, but it had not been bothering me. I have been putting a triple antibiotic cream on it for about 3 years. Now, it is beginning to have sharp pains and the cream is not helping.......Should I see a podiatrist (foot doctor, sorry about spelling) or a Dermatologist?	Hi, dear. I have gone through your question. I can understand your concern. You may have some wart like lesion like verruca plantar is. Or may have corn. You should consult for specialist and go for excision biopsy. Then go for histopathological examination and 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.
Answer the following medical question in a clear and concise way.	HI, My sister is 39 year old and married..She always think negative in every aspects. Other than close relative or close friends if any body(neighbours/relatives/friends) happy or doing progress in life, she feel bad. She don t have any stress as a house wife, maids are there for work. her In-law, husband and 17 old boy everybody loves her. She always remember bad memories of her life and start fight with everyone related to that matter. please help to solve her problem or suggest doctor.	Hello Vijay, Welcome to Chat Doctor forum. Your sister seems to be having a psychological problem causing paranoid thoughts and jealousy, anger, depression etc. This is common in people suffering from any disorders like manic depressive disorder, obsessive compulsive disorder or a personality disorder. The best way to confirm the diagnosis and start appropriate management is to consult a psychiatrist who after detailed examination can solve her problem. Please do not delay the consultation as in such cases the situation often worsens as time goes. In most cases the condition improves with medications like antidepressant or anti-psychotic medications and psychological counselling. Hope this answers your query. Wishing her good health. Regards
Answer the following medical question in a clear and concise way.	My son is two years old. His head, neck and hands feel really hot but according to the thermometers (I used different ones to make sure it wasn t caused by a faulty reading) he does not have a fever. Additionally he has a rash on his hands, both the backs and the palms and he often complains of stomach aches. What can be causing all this?	Welcome to the Chat Doctor I understand your concerns. Child Chat Doctor. This happens due to poor regulation by temperature control centers in brain I.e. Hypothalamus. Don't worry as it improves on its own by 5 years of age. As far as the rash is concerned, I will be able to guide you in a better way if you post me his photographs as direct query. Hopefully this will help you. I will be happy to help you out in any child related questions. Take care
Answer the following medical question in a clear and concise way.	What causes Triple A syndrome ?	What causes triple A syndrome? Mutations in the AAAS gene cause triple A syndrome in many affected individuals. This gene provides instructions for making a protein called ALADIN, whose function is not well understood. Within cells, ALADIN is found in the nuclear envelope, the structure that surrounds the nucleus and separates it from the rest of the cell. Based on its location, ALADIN is thought to be involved in the movement of molecules into and out of the nucleus of the cell. Mutations in the AAAS gene prevent this protein from reaching its proper location in the cell, which may disrupt the movement of molecules. Researchers suspect that DNA repair proteins may be unable to enter the nucleus if ALADIN is missing from the nuclear envelope. DNA damage that is not repaired can cause the cell to become unstable and lead to cell death. Although the nervous system is particularly vulnerable to DNA damage, it remains unknown exactly how mutations in the AAAS gene lead to the signs and symptoms of triple A syndrome. Some individuals with triple A syndrome do not have an identified mutation in the AAAS gene; in these individuals, the genetic cause of the disorder is unknown.
Answer the following medical question in a clear and concise way.	Ive had lower right abdomen pain for two years now. Ive had my appendix out, but it was normal. I recently started getting pale stool, with severe abdomen pain! Ive had a lower and upper gi as well as blood tests and cat scans. The doctors dont know what to do anymore, Help!	HI. Read your history and understood your problem. When all the tests are abnormal, and you still have pain on the right side of the abdomen, this is most probably IBS- Irritable Bowel Syn Chat Doctor. Since you have talked about pale stool, the probable causes can be ::Obstructive jaundice due to stone in the common bile ducts, pancreatic problems and so on. I would advise you to have a screening ultrasonography followed by MRCP and ERCPStool tests for stercolbilinigen. Urine for biirubinBlood for CBC and liver function tests. All tests will help to rule out the causes of pale stool and may be the reason for pain in abdomen.
Answer the following medical question in a clear and concise way.	I had shoulder surgery eight weeks ago and have run the gamut on pain meds...Percocet, Norco and then tramadol, have not had good luck with any of them and I stopped taking the tramadol on Saturday afternoon. Just trying to get by in ibuprofen and Tylenol. So go figure I have a bad headache today, only when needed I have a script for Fioricet and now wondering if it is ok to take at least one, it not two. I last took two Tylenol about 10am.	Dear patient what shoulder surgery was done and was it done for fracture or muscle tear needs to be mentioned.8 weeks is sufficient time, and you should be pain free now whatever surgery is done. Do not take painkillers without prescription as they also have side effects. I would like to advise X-ray of the involved shoulder anteroposterior and axillary views to check for the reason of pain. Please consult your operating surgeon with the X-ray as soon as possible. Thanks.
Answer the following medical question in a clear and concise way.	Just finish my period on the 13th it came on th 9th. And I was 5days late. And after my period am having lower back pain with cramp like period. Very annoying pain. And my my flow wasnt very heavy like it use to seem like it mixed with water light period. Pls help me doc.	Simply anemic and exhausted you are. Iron rich diet and some hot water fomentation over back will help. Occasionally may take analgesic tab but pl don't make it a habit. In Ayurveda Rohitakaishta + Dashmularishta + Lhasa in equal proportions will bring happy hrs back within two weeks to four weeks. It is safe and no side effects. May see Ayurveda doctor to get more guidance. Hope you get the hint to decide better.
Answer the following medical question in a clear and concise way.	Dear Sir From last 6-7 months i have itching on the whole body when i scratch it rashes will appear. i went to doctor he asked to do prick test. in that, the report came as it is from Dust. for that i am taking tablets from last 5 months(Laveta M) but still i am facing the same problem. Last year i faced sneezing ,Runny nose but now it is not their. can u please suggest the remedy for it?	Hi Dear thanks for your question, you're having generalized itching and from last six months and your patch test is positive for dust, Dear the permanent remedy for you is to avoid your allergens that is dust, if you can avoid dust, even by wearing a face mask at your work place that will give you permanent cure for allergic reaction of dust,otherwise you have to take medicine which your taking of allergy that is LAV ETA M.your runny nose is ALSO DUE TO DUST.
Answer the following medical question in a clear and concise way.	What are the symptoms of Dystonia 2, torsion, autosomal recessive ?	What are the signs and symptoms of Dystonia 2, torsion, autosomal recessive? The Human Phenotype Ontology provides the following list of signs and symptoms for Dystonia 2, torsion, autosomal recessive. If the information is available, the table below includes how often the symptom is seen in people with this condition. You can use the MedlinePlus Medical Dictionary to look up the definitions for these medical terms. Signs and Symptoms Approximate number of patients (when available) Autosomal recessive inheritance - Blepharospasm - Dysarthria - Dysphagia - Juvenile onset - Torsion dystonia - Torticollis - Tremor - The Human Phenotype Ontology (HPO) has collected information on how often a sign or symptom occurs in a condition. Much of this information comes from Orphanet, a European rare disease database. The frequency of a sign or symptom is usually listed as a rough estimate of the percentage of patients who have that feature. The frequency may also be listed as a fraction. The first number of the fraction is how many people had the symptom, and the second number is the total number of people who were examined in one study. For example, a frequency of 25/25 means that in a study of 25 people all patients were found to have that symptom. Because these frequencies are based on a specific study, the fractions may be different if another group of patients are examined. Sometimes, no information on frequency is available. In these cases, the sign or symptom may be rare or common.
Answer the following medical question in a clear and concise way.	hello doctor ,i had a child of 8 yrs andin sep 2011 i conceived i had abortion on 26 th sptember 2011 till today i did not get periods . i had done ChatDoctor test but it was negative on 12 th december 2011. but we want to have another child .what might be the problem	Hallow Dear, Usually 5 weeks after an abortion, the egg forming resumes. Starting of the period may vary, but is usually after 5-6 weeks. So even in spite of not having menses, the pregnancy is possible. If you are keen on having pregnancy, I would advise you to find out the day on which you release your egg (ovulation). This can be done either by ovulation monitoring kit or ultrasonography. The egg has life of 24 hours while the sperms are active for 72 hours. Hence, 4 days on either side of the day of ovulation is fertile period. Sexual intercourse in this period will give you good results. However, you will get the best results if you can have sexual intercourse on the day of ovulation. Otherwise, there seem to be no problem with your Chat Doctor test. Wish you safe motherhood,
Answer the following medical question in a clear and concise way.	Hi, I am taking primolut N to prolong my period by a couple of days. I am scheduled to start my period on Tuesday 16 October but prolongging until end of next week. I am not on the pill do I stand a chance to still fall pregnant if I have unprotective sex	Hello dairy understand your concerned are on primal N to delayed period since last week. If you did sex when you are on prim out N then it itself act as contraception and prevent pregnancy. But if you did sex before starting prim out N and during fertile phase of period then there is chance of pregnancy. If period will not occur 7 days after stopping prim out N then go for urine pregnancy test and or blood Chat Doctor test to confirm pregnancy. Avoid stress, take health diet, Chat Doctor.
Answer the following medical question in a clear and concise way.	Isn t it true that sharp pain in one s right shoulder could indicate parasites in the small and/or large intestines (i.e. amoebic dysentery) which could be seen by the host (amoebic cysts and trophozoites...all stages of development) in one s stool, cause bloating, gas, stomach distention, terrible abdominal pain, diarrhea, constipation and progressively get worse if not treated with the appropriate antibiotics and eventually cause the death of the host? Fact or Fiction: Amoebic dysentery has been eradicated in North America. Amoeba and trophozoites cannot be seen by the naked eye. Amoeba generally float on top of the toilet water, easily visible. Standard O&P lab tests cannot detect amoebas and trophozoites. The infected stool must be submitted to a lab that has the special equipment and appropriately trained personnel in order to detect amoebic dysentery disease. Two or more antibiotics will be necessary to eliminate such parasites; long term if the host has been infected over a long period of time. Thank you, Edward DeBusman	Hi, There is no direct relationship between intestinal infection and shoulder pain. Reasons for both are entirely different. The intestinal infection will lead to diarrhea, bloating and indigestion but not shoulder pain. Reason for shoulder pain may be muscular pain or joint abnormalities. A detailed clinical examination is needed to assess the cause of shoulder pain. Hope I have answered your query. Let me know if I can assist you further.
Answer the following medical question in a clear and concise way.	What is (are) Wounds and Injuries ?	An injury is damage to your body. It is a general term that refers to harm caused by accidents, falls, hits, weapons, and more. In the U.S., millions of people injure themselves every year. These injuries range from minor to life-threatening. Injuries can happen at work or play, indoors or outdoors, driving a car, or walking across the street. Wounds are injuries that break the skin or other body tissues. They include cuts, scrapes, scratches, and punctured skin. They often happen because of an accident, but surgery, sutures, and stitches also cause wounds. Minor wounds usually aren't serious, but it is important to clean them. Serious and infected wounds may require first aid followed by a visit to your doctor. You should also seek attention if the wound is deep, you cannot close it yourself, you cannot stop the bleeding or get the dirt out, or it does not heal. Other common types of injuries include - Bruises - Burns - Dislocations - Fractures - Sprains and strains
Answer the following medical question in a clear and concise way.	what can 1 do for panic attacks? if having them and how uid the three way cheep to stop then ? what can you do for panic attacks in whats the cheapest way to solve them and keep that from happening my friend is having panic attacks and dont have much money for Dr? Like maybe home remedies	Hello, Thanks for choosing Chat Doctor for posting your query. I have gone through your question in detail and I can understand what you are going through. Panic attacks can be best controlled with medicines(paroxetine) (mirtazapine) or it can be controlled with cognitive behavioral therapy. But both of them will cost you. The easier way is start some regular aerobic exercises. These will improve the exercise tolerance and also improve the panic attacks. Hope I am able to answer your concerns. If you have any further query, I would be glad to help you. In future if you wish to contact me directly, you can use the below-mentioned link:bit.ly/ Chat Doctor.
Answer the following medical question in a clear and concise way.	I am going to the hospital from past one weeks, and through ultrasound doctor has confirmed 85% of abdominal Tuberculosis. But again doctor has ask for the test of ascetic fluid for TB PCR test and skin test and it will take again 3-4 days. so i want to know is it good to stretch this case so long? does it harm more?	Dear Friend. Hi, I am Chat Doctor, I have read your query in detail, I understand your concern. Mostly diagnosis of Abdominal Tuberculosis is based on Clinical, USG, CENT Abdomen. If you have ascites also, then ascetic fluid examination can also tell us that it is TB or not.It's not about stretching the case, it is all about making a perfect diagnosis. So, this is what is required. Get tested, be sure and get perfectly treated. This is my personal opinion based on details available here. If you still have any other query, you may please ask me. Stay Healthy. Chat Doctor, MD
Answer the following medical question in a clear and concise way.	dear sir, i am using s zetalo 10 mg since 4 years i want to know is it is used continuously there any chance of side effect. i tries so many times to stop to medecine but after 4 days of non usage my body will shiver, so again started to take the medecine. please suggest me	Hi, Zetalo is a selective serotonin re-uptake inhibitor commonly prescribed to treat depression, obsessive compulsive disorder, anxiety and other conditions. Its common side effects include sleep disturbances, sexual dysfunction, Chat Doctor. If you stop taking it suddenly it may cause anxiety, irritability, headache, vertigo, and abnormal movements. If at all you wish to stop it the dose of this medicine should be gradually reduced under the supervision of your doctor then an alternate effective but a safer
Answer the following medical question in a clear and concise way.	severe pain left leg knee to ankle. Lasts about five minutes and goes away. seems to hurt through the bone and all around the lower leg. Can t stand or walk during this time, too painful. This doesn t happen very often. could be weeks or months before it happens again.	Hello, High uric acid levels cause knee or ankle pain. Intense pain is experienced & repeat attacks may occur if uric acid levels are not under control. Get investigated, get Urinalysis, Synovial fluid analysis, Uric acid test (urea & creatinine), Imaging tests (CT, MRI, USG) to rule out gout, septic gout or pseudo arthritis. Your treatment will depend upon the severity of your illness diagnosed. You can take acetaminophen (Tylenol), NSAIDs (Naproxen). Do not stress unnecessarily. Keep your knee elevated on a pillow while on bed to reduce discomfort. Hope I have answered your query. Let me know if I can assist you further.
Answer the following medical question in a clear and concise way.	So my lower lip frenulum hurts. when I move the muscle in my lip or when I play with it it hurts a lot. I m not sure if the pain is causing a headache or not. I would like to know what is causing the pain and how I get it to stop. I have a dentist appointment tomorrow Monday the 19th is there anything I can ask them to do to help me.	Hello, I can understand your concern. Lower French is a muscular septum. Pain in the French can be due to trauma to it by hot or hard food. It may also be felt if it is about to develop an ulcer. The ulcer may not be seen by now but may develop in 1-2 days. None of these problems are severe and can be managed by painkiller like Acetaminophen 500 mg or Ibuprofen 400 when needed. If an ulcer develop, local application of Endocrine gel (McCoppin) or Colonel will help. You should be fine within a week. You can also delay your appointment for a week for the examination in case you are not pain-free in a week. I hope this answer helps you. Thank you for choosing Chat Doctor. Let me know if you have follow-up questions. Best,
Answer the following medical question in a clear and concise way.	Hello Doctor Rynne, For the past 2 months, I have been experiencing memory impairment on a daily basis. This disturbs/concerns me because I am a college professor. I will be lecturing in class and then forget the point I want to make. I am in a meeting and wanting to make a point and then forget... This is happening too frequently. I am a 56 year old Korean American female in good health. My last period was February 26th, 2014. I understand that peri-menopause could cause this but I still am very worried.	Well in order to discuss the treatment first it must be determined what the cause is. Actually even that follows a careful evaluation to determine whether there is a real memory impairment or perhaps that impression is given by lack of attention often in the setting of issues like anxiety or depression sometimes associated with menopause. If a true memory impairment is found, other higher brain functions language, judgement, complex motor skills are tested as well. Afterwards as I said the cause must be searched for. There can be many causes like hormonal and metabolic alterations, nutritional deficiencies, toxins, vascular or degenerative impairment of the brain etc., some of them reversible some not. So such a vast array of possible causes often means having to take much blood or imaging test in order to make a diagnosis. As might have understood from this long explanation it is impossible to make an accurate diagnosis and hence to responsibly answer your question about treatment, I think you should contact a doctor, possibly a neurologist.
Answer the following medical question in a clear and concise way.	Hi..I had a major accident on 3/3/17 as a car collided with me in my right knee, while I was riding a bike. The accident was so bad that my right hip is dislocated my knees got separated from each other, as it is still under the skin. I had too fractures on my right tibia and left femur. I have been operated on the day of my accident and after that on 8/3/17 the later fractured parts. Know after recovering from hospital.my doctor feels that my right knee ligament is being damaged and I need to consult an sportsmed doctor. Can u suggest me what shall I do do further treatment or ne other therapies I go for. I heard that my ligament operation will cost a higher amount! I am in dilemma, plz help me out.	Hi I have read your question and understood your concerns. Seems that the initial injury has done quite a bit of damage to your leg. The main issues that I can see are:1. Fracture of the right tibia2. Fracture of the left femur3. Dislocation of the right hip4. Dislocation of the kneeing the initial part the main objective is to reduce the dislocation and treat the fractures, which was performed as you stated. I will also assess for any nerve or circulation damage which does not seem to be there. However, it will take a few weeks to months for the bone to regain adequate strength to allow for weight bearing. Once bones are healed, and you are ambulating without any aid, you will notice that the knee is more "loose" than usual or compared to the other side. With a history of knee dislocation there is a high likelihood that you have injured at least two or more of the ligaments around the knee. The treatment will basically depend on your level of daily activities and also your symptoms. However, performing the surgery will not be as urgent as the initial surgeries to treat your fractures. You can opt to go for physical therapy and strengthen your muscles which can help in stabilizing your knee and reduce your symptoms. Some ligaments do eventually scar down, and you will have fewer symptoms of a loose knee. However, if you are a very active person who does demand a lot from your knee than I do suggest you go ahead with the reconstruction. Earlier stabilization will lead to earlier rehabilitation and better function.
Answer the following medical question in a clear and concise way.	Hi I am 30 years old and suffer from lower back pain 24/7. My MRI results say I have L4-L5 left for aminal disc protrusion and annular fissure causing moderate neuroforamina narrowing. I ve taken medicine for the pain ( Medrol. Norflex, Percocet, Toradol, Keralog and neurontin) but none seem to help. I can t walk , stand or sit for more than a couple of minutes and recently I ve been experiencing a tingling cold sensation on both of my feet and left arm. Is there some kind of theraphy to help ease the pain and help with the other symptoms I m experiencing, or surgery is really necessary??? Thanks T	The cold sensation in feet and left arm is because of the compression of the sensory nerves in spinal cord. Well, looking into your young age you may have several optionsSurgery is one option which may give miraculous results. There are two options - one is open surgery and other is through a scope. The protruded disc material can be removed.Also, Ozone Therapy can be tried. Physiotherapy is a double-edged sword. It may give good results, or it may lead to stoppage of whatever little motion you have left.
Answer the following medical question in a clear and concise way.	went to the doc today thinking i had the crud. over the weekend i woke up vomitting and thought it was food poisoning and i have had diarrhea ever since with some stomach pain. the doc said it may be my appendix. she put pressure on right lower abdomin and ever since i have had some pain and also vomiting. what do you think	Hi. Thanks for your query and an elucidated history. Curd causing a gastroenteritis not heard of in fact can help in restoring the bacterial flora as it is a probiotic. Since you have now got a pain in the area of appendicitis after putting a pressure and your Doctor has suspected appendicitis, I would request you to get your Blood, urine and stool checked. Also, to get a confirmatory diagnosis by Ultrasonography and / or CT scan and t go for a Surgery if present on investigations.
Answer the following medical question in a clear and concise way.	Hi! My Mother is Suffering for Intestine & Stomach Cancer Doctor had done operation and remove large intestine & Half stomach part from her body now when she eats some food it is not digested properly immediately she has to go for fresh up any light food also she is not able to digest liquid also. please help me.	Hi, Thanks for writing in. If your mother has got part of stomach and large bowel removed due to surgery then the stomach volume is reduced and digesting capacity is less. For this she should take small meals every 3 to 4 hours and avoid large meals. She can take fruits, salads, snacks and foods in small amount and this should be given frequently. She should not do fasting. For liquids, she might take smaller amounts at a time and this will be tolerated. Spicy food must be avoided for her, and she can take digestive enzymes. Please do not worry.
Answer the following medical question in a clear and concise way.	Hello, My father-in-law was recently diagnosed with adenocarcinoma with signet ring cells of the stomach, they said 2/3 of his stomach is affected. My question is should he be doing something immeadiately doctors have gene test scheduled in 10 days, what will that accomplish if the cancer is growing?	Hi, dairy have gone through your question. I can understand your concern. Your father has adenocarcinoma of stomach. Treatment depends on type and stage of stomach cancer. However, primary treatment is resection of stomach and end to end anastomosis. Further treatment options are chemotherapy, radiotherapy and molecular agents, but it depends on exact stage and spread of cancer. Consult your doctor and go for surgery as early as possible. Hope I have answered your question, if you have any doubts then contact me at bit.ly/ Chat Doctor. Thanks for using Chat Doctor. Wish you a very good health.
Answer the following medical question in a clear and concise way.	Im always tired, and cry a lot over nothing sometimes I dont know why Im I fart a lot but dont poo as often as I should and I wee a lot... And I get sick really easily Im 12 years old this year and Im male. Do you know whats wrong with me? Or is it natural? My mum is a nurse and she doesnt think it is natural.	Degree understand your concerns went through your details. I suggest you not to worry much. I suggest you are over working your brain. At the age of 12, you are too immature to understand about mood swings. You must be upset because your requirements are not fulfilled, or your needs are not met. Tired because of the disappointment related to the above happenings converted into laziness and in turn tiredness. Your mother, being a nurse, knows you, your problem and what you require. Just obey her and concentrate on your studies and mischief. Your duties are just two things - studies and play. Do it properly. 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.
Answer the following medical question in a clear and concise way.	My son passed away suddenly after suffering three months with MRSA that he got after a simple back surgery to shave the disc off the nerve in his back. The back had to be left open to heal for three months......he suffered so much. The day before he dropped dead, his c reactive protein levels were 178. How dangerous is that level?	My prayers are with you for this terrible tragedy. C-reactive protein is a nonspecific marker for inflammation, so the levels themselves aren't said to be dangerous. However, very high levels (which your son had) indicate a very severe inflammatory or infectious process going on. This could happen if the MRSA had spread into his bones or blood, or was somewhere in his body causing a chronic infection. Hope this answers your query. If you have further questions, I would be happy to answer them.
Answer the following medical question in a clear and concise way.	I have bright red small round dot rash on both my lower legs. I noticed this after I received a pedicure where they used hot stones on my legs. I think I had shaved my legs that morning. I have it over 2 months & I thought it would go away. It did not so I went to a dermatologist 8 days ago & she gave me a RX for Cordran SP 0.05% Cream-apply twice a day. 2 days ago I noticed my rash was worst & now I have it on the backs of my upper arms. Would the cream make it worse? I also had been taking Amoxicillin 875mg twice a day for a sinus infection for 10 days and finished that medicine 3 days ago. Any connection?	Hi and thanks for the query, it is important to exclude any infectious process that could be involved in this process. Considering that manipulation was made at the level of the skin, it is possible that a germ, skin located could cause such an inflammation. However, a proper clinical review is needed to determine whether this is simply due to irritating action of the pedicure process or products, or due to introduction of an infectious agent. It is possible that it could be an infection. I suggest you consult your doctor. Kind regards
Answer the following medical question in a clear and concise way.	When I walk up or down the stairs my ankle freezes up and I have horrid pain it does not last for very long however I have fallen down if I do not hold onto to the hand rail. I also have knee and hip pain are all of these things related? I take Arthrotec 75 for pain...	Hello, I read carefully your query and understand your concern. Your symptoms seem to be related to arthritis. Arthritis may cause inflammation and freezing of the joints. I suggest using anti-inflammatory medications such as Acetaminophen to relieve the pain. I also suggest using anti-inflammatory cream such as Voltaren cream for local application. Hope my answer was helpful. If you have further queries feel free to contact me again. Kind regards! Chat Doctor.
Answer the following medical question in a clear and concise way.	i am 36 weeks pregnantand there is lot of itching all over my doctor hasd prescribed Tab cetrazine and udiliv once daily For two weeksand told come for blood tests is it anything serious? also let me know if these tablets are safe during pregnancy	Hello dear, I understand your concern. In my opinion the itching all over the body during the last trimester might be routinely seen in pregnancy. But it is always better to evaluate by doing liver function test. If they are normal the itching can be considered physiological. Nothing to worry. Tab.cetirizine and Adílio are safe to take during pregnancy, and they are usually given at times of itching or allergy in pregnancy. So relax mostly the itching might be physiological. Best regards...
Answer the following medical question in a clear and concise way.	Hello Sir, I have 3-4 small & big lumps or muscles bolt in my stomach area, waist area, 1 on thigh & 1 on arm. When I am pressing them, its paining in that lump/ bolt only. I do not have any kind of other problems. I do not take any kind of tobaco items except rare beer montlhly may be once but not evrymonth , sometime. I am gym guy & do regular exercise. My height is 181cm & weight 78kgs & 32yrs old. I would greatly appreciate if you could suggest me what kinds of step i should take. Can I go for x-ray, what kind of xray.. Kindly suggest me on this.. Thank you!! Sincerely, Kailash	Hi Baileys. Thanks for your query. From the nice history you have provided of the multiple non-symptomatic lumps over abdomen and thigh, arm and waist, these look to be multiple Lipomas. Nice to know that you do not take tobacco and are a Gym guy. Kind of steps you should take ::-Consult a General Surgeon, get a clinical evaluation and physical examination to get a diagnosis.-Only FNAC is required.-The best way is to get all of them removed for 2 reasons 1. You get all the lumps out of the body before they get slowly enlarged.2. You get a certain diagnosis. Do not worry-the other ways is to get the following lumps out of the body:-Enlarging suddenly-Become painful-On joints-In muscles.Otherwise, get a confirmed diagnosis and relax. Remember there are no medicines for such a condition, hence do not try anything.
Answer the following medical question in a clear and concise way.	Dear Dr. Purnendu Roy,I have benn posted in West Bengal now. Here the doctors detected Gall stone (24mm) and recommended for surgery. Then last week I visited CMC, Vellore where I was adviced for surgery. But as the Doctors in CMC are preoccupied they have scheduled the same in April 2011. I am afraid of surgery. Kindly advice and if the surgery is inevitable where can I get it done in a better organized way?With best Regards ;M H Rahaman	Hi, I thoroughly read your query and understood your concerns. Gallstones are small stones that form inside the gallbladder. Gallstones pain (Biliary colic) usually is experienced when the gallbladder contracts in response to a fatty meal. This compresses the stones, blocking the opening. As the gallbladder relaxes several hours after the meal, the pain subsides.1. Biliary colic -"The pain without cholecystitis- gallbladder infection/inflammation" - usually subsides within few hours to a day. Acute cholecystitis secondary to gallstones may be continuous and accompanied by fever. 2. Medical therapy is an option for gallstones, though a vast number of surgeons around the globe prefer removal of gall bladder-surgical intervention. Medical therapy includes intake of ursodeoxyholic acid (UCA) for a period of 12 to 24 months. UCA has been shown to inhibit biliary secretion of cholesterol, reduce intestinal absorption of cholesterol, increase hepatic bile secretion, and improve gallbladder emptying. Medical therapy is useful if mild symptoms, stones are smaller (weight reduction and low-fat diet is also a part of medical therapy.3. Surgery lasts for less than one hour (usually half an hour). Laparoscopic surgery has greatly reduced surgery time duration and surgical complications. You may travel 7 to 10 days after surgery, though the surgeon may indicate precise time. I would also like to mention that gall bladder is removed completely in surgical intervention which may impair fat digestion. You maybe asked to cut fat completely from your diet (or keep to minimum) after gall bladder surgery. Hope to answer your concern. Wish you good and sound health. Let me know if I can assist you further. Chat Doctor.
Answer the following medical question in a clear and concise way.	I am having an allergic reation to something but I dont no where to start to figure out whats wrong. I start having very itchy hands followd by a rash that covers my whole body. Then I start vomiting and having severe diarreha and passing out, this usually last a fews days then it is gone. Each time it has happened it just so happens i have eat wheat noodle or wheat bun	HI, thanks for using Chat Doctor Allergic reactions can involve the skin and other areas of the body including the stomach and intestines (the vomiting, diarrhea). You may want to consider allergy tests to find out exactly what is causing the reaction. This can be in the form of skin prick tests or a blood test. Once the exact cause is determined then you can eliminate or reduce your exposure. I hope this helps
Answer the following medical question in a clear and concise way.	.Dear sir, im Anosha, 29 years old mother and I have 7 months old baby. I have hypertension for 2 years when I was a girl.it was indicated 150/100. many investigations have been done. but every report is normal. now Im taking Atanalol (50mg) bp as a drug. is this essential hypertension? please be kind enough to answer me.	I read your question carefully, and I understand your concern. Since you say that all tests have resulted normal (since you do not say which tests I will have to assume that all the necessary tests to exclude secondary hypertension were done) then your case can be considered essential hypertension. As for treatment with Atenolol, yes, it is one of the most used treatments, among the safest ones and particularly suitable for your age. So you can continue taking it, of course monitoring blood pressure from time to time and having regular check-ups with your primary doctor. I hope to have been of help.
Answer the following medical question in a clear and concise way.	My 5 year old has been running a fever for 2 days. I can keep it down with motrin/tylenol. When medicine wears off it is around 102 degrees. She also has excessive burping, like more in her throat than a large external burp. Any suggestions? She doesn t really have any other symptoms. She threw up once from the first night. She has been drinking tons of water. Her stool is a little loose.	Hi... Thank you for consulting in Chat Doctor. Fever of few days without any localizing signs could as well a viral illness. Usually rather than fever, what is more important is the activity of the child, in between 2 fever episodes on the same day. If the kid is active and playing around when there is no fever, it is probably viral illness and it doesn't require antibiotics at all. Once viral fever comes it will there for 4-7 days. So do not worry about duration if the kid is active. Paracetamol can be given in the dose of 15 mg/kg/dose (maximum ceiling dose of 500 mg) every 4-6th hourly that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol. It seems your kid is having viral diarrhea. Once it starts it will take 5-7 days to completely get better. Unless the kids having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry. 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.
Answer the following medical question in a clear and concise way.	Hi, may I answer your health queries right now ? i am 18 years old nd i have lots of pimples nd dark spots on my checks nd a few on my forehead can u plz suggest me any technique to get rid of these in 30 days...plzzzz its urgent.....i tried medices priscribed by dermetologies nd went to beauticians ....used various creams but no use.....so plzzz help me out....plzzzz	Hi...dear samasusmi..., Thanks for choosing Chat Doctor., PIMPLES....called ACNE VULGARISM...are common., in your age...due to hyperactivity of Sebaceous glands., by Polydorus Acne bacteria ok., Course of treatment is important., Here U must follow 35 days treatment., U will get complete remission.,1) Frequent washes with FAST BAR.,2) Tab. Isotretinoin 20 mg (Accurate) daily morning times.,3) Topical 1% Clindamycin (Zycline-nano.Camila). 2 times daily.,4)Tab. Azithromycin 250 mg daily for 5 days.,5) For Dark spots.........go for Chemical peels., Dermabrasion., laser therapy., on dermatologists supervision6) Take plenty of green vegetables, carrots and fresh fruits., Avoid fried, spicy and junk foods..., take care...than
Answer the following medical question in a clear and concise way.	Hai! Doctor. now my age is 26. i am masturbating from my Age 15 upto now. such a masturbating will be defect my life that means after marriage i can intercourse with my wife well. such behaviour will defect my life or not. it is wrong or right. please answer me.	Thanks for contacting Chat Doctor with your medical question. You are concerned that masturbating will affect your marriage and sex life. Masturbation is a normal thing men do. Excessive masturbation can lead to less interest in having sex with your partner and lead to poor relationships. Therefore, I recommend that you reduce your masturbation and focus more attention on your wife and your relationship. Medically masturbation can lead to low sperm counts and infertility. If you are having troubling getting your wife pregnant then reducing masturbation may improve your chances of pregnancy. Hope this answers your question. Please contact us again with your medical concerns and questions
Answer the following medical question in a clear and concise way.	i have a hard lump on left side of neck next to my throat that will not go away. dr. said my throat was swollen and put me on anti-biotics. didnt really help, she said my throat looked better but was still red and the lump is still here. it has been around 7 weeks now. what could it be	Hi, dairy have gone through your question. I can understand your concern. You may have enlarged cervical lymph node. It can be due to reactive hyperplasia, tuberculosis, lymphoma or metastatic carcinoma. You should go for fine needle aspiration cytology or biopsy of that hard 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.
Answer the following medical question in a clear and concise way.	When I feel I am in pressure situations and I become so tensed nervous my palms and foot goes cold sweaty and when I stand my feet shakes, my heart palpitates, and I go in a state of trance when i could not memorize the things to be said or written in (exam, presentations, etc). Specially in situations where I dont know what to expect. I have nausea when I am nervous.	Hi, It seems you are suffering from anxiety disorder with performance anxiety predominating. You can choose to start management with medications or behavior therapy or botChatDoctorbined. I would advise you to meet a local psychiatrist. One of the SSRIs like paroxetine would be a suitable agent for you. In addition, you can start doing some relaxation exercises like progressive muscular relaxation which will help you relax. Wishing you speedy recovery.
Answer the following medical question in a clear and concise way.	Hi Doc, My mother got the hair dye allergies as bumps in the forehead and also near the eyes. She had V care hair shampoo cum hair dye 2 days back. Since the swallon got increased marginally we took her to the near by dermatologist. Doctor has prescribed defcort -6mg, cetrizine & pantocid D cap. Do we need to do any further action on this. How long will it take to recover. Is there any food restriction while taking this medicines. Kindly suggest us	HI, thanks for using Chat Doctor The effort is a steroid and the cetirizine is an anti histamine. These medications should be adequate to treat her allergic response. There should be some improvement within 24 to 48 hours. It may not be complete improvement at that time, but it would then continue to resolve. There are no food restrictions, but she should make sure that she uses the steroid on a full stomach to avoid irritation of the stomach lining. It should be used on mornings after breakfast or tea. I hope this helps
Answer the following medical question in a clear and concise way.	i m 50 yrs, i have 2 stones in left kidney, recently sonography result shows same with collapsed gallbladder. i want to know in absence of gallbladder functioning bile will accumulate in liver then how body will remove accumulated bile from liver or what should i do . please advise. more which future complications it may lead regarding my health and which precautions should i take to prevent it. please guide me.	Hi and welcome to Chat Doctor. Thank you for your query. I am Chat Doctor, I understand your concerns and I will try to help you as much as I can. It may lead to few weeks of certain digestive problems such as bloating, nausea or diarrheas which should not be significant. It should stabilize after this period and bile volume is not affected by gallbladder removal. I hope I have answered you query. If you have any further questions you can contact us in every time. Kindly regards. Wish you a good health. Chat Doctor.
Answer the following medical question in a clear and concise way.	Dr. My question is about the hypertention. Iam using medicines but also i do a lot of excercises its overyears now iam also observing my diet. I always get nomal levels after medicine and other remedies such as Garlic lemon juice early in the morning with empty stomuch but after some times it shoots again to abnomal level. What is the serious problem. My kidneys are okey and no other complications.. Can you advise please. Iam now 61 years old..l	Hi, One thing is very obvious as far as the hypertension is concerned. If you go on measuring the blood pressure on your own, it shows great variation every time you measured and this is happening due to over consciousness. Such reading may not be taken into consideration for medicine, actually, blood pressure needs to be measured by a physician. Measuring blood pressure on your own does not prove anything. It is just a monitoring and anyhow you have to see the physician for final confirmation. So if you get high blood pressure then consult the physician for confirmation and let the physician decide for any changes in medicine and other, else balance diet, exercise, low-calorie diet, cut down salt in the diet. You have not given the blood pressure measurement. Hope I have answered your query. Let me know if I can assist you further.
Answer the following medical question in a clear and concise way.	What to do for Hemolytic Uremic Syndrome in Children ?	- Hemolytic uremic syndrome, or HUS, is a kidney condition that happens when red blood cells are destroyed and block the kidneys' filtering system. - The most common cause of hemolytic uremic syndrome in children is an Escherichia coli (E. coli) infection of the digestive system. - Normally, harmless strains, or types, of E. coli are found in the intestines and are an important part of digestion. However, if a child becomes infected with the O157:H7 strain of E. coli, the bacteria will lodge in the digestive tract and produce toxins that can enter the bloodstream. - A child with hemolytic uremic syndrome may develop signs and symptoms similar to those seen with gastroenteritis, an inflammation of the lining of the stomach, small intestine, and large intestine. - Most children who develop hemolytic uremic syndrome and its complications recover without permanent damage to their health. - Some children may sustain significant kidney damage that slowly develops into chronic kidney disease (CKD). - Parents and caregivers can help prevent childhood hemolytic uremic syndrome due to E. coli O157:H7 by - avoiding unclean swimming areas - avoiding unpasteurized milk, juice, and cider - cleaning utensils and food surfaces often - cooking meat to an internal temperature of at least 160 F - defrosting meat in the microwave or refrigerator - keeping children out of pools if they have had diarrhea - keeping raw foods separate - washing hands before eating - washing hands well after using the restroom and after changing diapers
Answer the following medical question in a clear and concise way.	I had a cesarean 5 months ago but I don t think that is related. I had a 24 hour stomach viruses yesterday and now I have what feels to be gas bubbles in both my shoulders, at the tops, where they juncture with my neck. It only really hurts when I breathe in deep or laugh. How can I get this pain to go away? I have been rotating my shoulders but that doesn t seem to be helping.	Hi welcome to Chat Doctor ... This type of pain on breathing can occur also from viral muscle ache or from musculoskeletal pain..... But before that work up needed to rule out cardiac and respiratory causes..... 1.auscultation 2. EKG 3.chest x-ray 4.CRP etc.... According to cause further treatment given... If infective etiology than antibiotic might be needed... If no significant cause found than ibuprofen needed for muscular pain. Take Paradise :Pulmonologist consultation for examination and further work up... Hope this will help
Answer the following medical question in a clear and concise way.	kid 4 year old had fever and crocin (6ml) was given, after 1hr the fever was still shooting and the temp became 101.8 and gave meftal ( 5ml). should this be fine or is there any other suggestion ? please note the child has seizure history aswell earlier	Hi, Meftal and Cronin both are good antipyretic medicines. It will take some time to act to bring down the temperature. Now over and above Cronin, you gave Metal, it will start working now and fever will go down. Important is to give more water so that there will be profuse perspiration bringing down the temperature.If you require apply ice pack on forehead or abdomen. As there is h/o seizure, if fever does not go down, consult your doctor. Ok and take care.
Answer the following medical question in a clear and concise way.	phisicians is needed C-4 n C-7. are all fused. I also have a herniatef disk lower bsck. i moved too loiisiania n now i cant find a pain msnsgment doc. I hsbe been on meds since 1989. And educated ..liver fllare up caused my nuero. to put. me on opjiates n muscle relaxer since 1996. I been off my mefs . n bedridden. for two mths. what can I do to get a doctor. er says i need a foc asap. plus im trying too settle my workcomp. case of 1989. since 1993 in state of ct. know attorney will take it so im doing it my self. this is why i dont have a doctor. please advice. my heart rate at. 190 over 80. alot. pain is erratic n acute.	Yes, heart rate can be elevated due to the impact of severe pain. The pain is also probably provoking anxiety. So you should seek treatment/medications to calm your system, such as antianxiety treatment. And since that involves seeing a doctor, you should be evaluated for inherent high blood pressure as well. And of course, better control of the pain will allow for less shock to your system, so getting back on your pain meds will help that also.
Answer the following medical question in a clear and concise way.	i have a 4.5 cm ovarian cyst , i was married in nov 14th , but still i have not concieving , can i because of cyst , i had irregular periods , so dr. put me on birth control pills for 3 months and then on progyluton for 4 months , suggest me what should i do now , i want to be a mom	Hi I think you should go for an ultrasound again to see for the cyst and also the number of follicles in each ovary. Do the scan on second or third day of your periods. If cyst has resolved and follicles number is more than 7 to 8, then you can try naturally for 6 months. Moreover, you can also track your follicles' growth by repeated ultrasound. If ovulation is occurring then don't worry. If not, then you may need some medicines like camphene for ovulation induction. Ask your doctor regarding this. Hope I have answered your question. If you have any other query I will be happy to help.
Answer the following medical question in a clear and concise way.	Hi 4 months ago I hurt my knee. I had an MRI and it said I tore my MCl and had arthrofibrosis. My knee has gotten a lot better and my doctor thinks im on the right track and isnt doing anything else. I think theres something else wrong. My knee feels squishy and unstable. It buckles when i try and walk fast. I m not comfortable with returning back to sports with fear of hurting it again. What should I do?	HIF you have MRI scan report, kindly write the impression written at the end of report or send scanned report to this forum or my email [email protected] you buckle during walk, means cruciate ligaments and or meniscal injury may have occurred. You have a. Choice to show to an arthroscopic knee surgeon who can visualize the extent of damage by arthroscope and one who is expert in preparing ligaments and meniscal injury in same sitting else, open surgery after Arthroscope if extensive lesions are therefore a knee brace long one till you reach the arthroscopic surgeon for evaluation and avoid walking without knee support. Best wishes
Answer the following medical question in a clear and concise way.	Hi Dr. Nirja Chawla I just wanted to check with you, that is it guaranteed that you get pregnant after taking 1 dose of fertomid. In my case I went for tubal litigation in October last year and this year end of June I went back to the hospital for reversal. Is it possible to cenceive early. I was turning 35 years this year June. Please help	Hereafter tubal ligation REVERSAL "is it guaranteed that you get pregnancy" ? Fatimid (camphene citrate) used in :Ovulatory infertility and dose is 50 mg daily for 5 days starting on the 5th day of menstrual cycle or any time if there is amenorrhea. It is clearly written in books that start on 5th day and for 5 day, so no "GUARANTEE" with single dose. Age 35 years is no problem in getting pregnancy. Personal knowledge of any doctor may be different, but scientific proof is that it advise for 5 days. Hope this information will be helpful for you.
Answer the following medical question in a clear and concise way.	I have a large pocket of fluid on the side of my knee. When drained I typically have around 200 CC removed. It returns completely within 3 days of being drained. An MRI found Osteochrondromitotic globulets. My WBC is 18,000. I do not remember hurting my knee in any way. The knot just showed up about a year ago. What could possibly be causing it?	Knee effusion, colloquially known as water on the knee, occurs when excess fluid accumulates in or around the knee joint. There are many common causes for the swelling, including arthritis, injury to the ligaments or meniscus, or when fluid collects in the bursa. This condition is known as prepatellar bursitis. Knee effusion is a large bursa between the inferior part of the femur and the tendon of the qua Chat Doctor. It usually communicates with the cavity of the knee joint and is pathologically distended with blood or synovial fluid in suprapatellar bursitis ("water on the knee"). A small amount of fluid exists in normal joints. When a joint is affected by arthritis, particularly an inflammatory arthritis such as rheumatoid arthritis (RA), increased abnormal amounts of fluid buildup, the knee appears swollen. The fluid is produced by the tissues that are affected by the arthritis and that line the joint.
Answer the following medical question in a clear and concise way.	Hi,doc I am 40yrs,5.1 tall,72kgs,diabetic,B.P.,both my sugar and B.P are under control. 2nd aprl my scan report showed borderline spleenomegaly,fatty liver. Itook homeo medicines now the scan report done on 6-6-2011 shows normal spleen and fatty liver changes and most important right ovary has acyst of 5.2/4.5 cm and fine septation and also impression is right ovarian infected cyst, i am on homeo treatment but worried. Please comment.	Hi thanks for contacting Chat Doctor... Noted you have fatty liver and ovarian cyst.... Here ovarian cyst can be simple functional cyst like follicular cyst.... For that hormonal pill taken for one month.... Mostly it will dissolve within month. If still not decreasing then laparoscopic removal done and histopathological examination done for rule out malignancy.... For fatty liver cut of oil in diet. Regular light exercise... Green leafy veg more like.....-spinach -arugula -dandelion -Brussels sprouts etc.... Carrot, Indian gooseberry good to take.... Junk food, red meat avoided.... Aloe vera and lemon juice useful. Take Care... With keeping my suggestion in mind consult doc. Chat Doctor.
Answer the following medical question in a clear and concise way.	I m overweight 93 kg ht173 I have fatty liver 2/3 & liver enlarged I want to lose wt I have abnormality in cholesterol levels I take METADOXIN 500 daily 1 & ATORSAVE 20 daily 1 My main problem that I want to lose 25kg wt please advise YYYY@YYYY Mob:0000 india mumbai	Hi thanks for asking question in Chat Doctor. Noted you have fatty liver and high cholesterol with overweight.... To reduce weight along with less fatty diet you have to burn calories .... Every day do one hour swimming or running... Take less fried food. Fruits more ... Cheese, burger, pizza, meat like trans fat avoided..... Use less oil in cooking .... Avoid sedentary lifestyle..... You will get benefit by above measures... Take care.... Chat Doctor.
Answer the following medical question in a clear and concise way.	My elderly father is experiencing excruciating back spasms. He has been moving between a chair and a bed for the past week, due to illness. His illness is better, back much worse. I am using ice, a lidocaine patch every 12 hours, and arthritis strength tylenol as directed. Any suggestions other than the ER?	Hi. I am glad we connected. The symptoms you have mentioned may be seen with a systemic or local cause that causes the muscles to contract. This can be seen when toxins in the area are affecting the muscles and causing them to remain tetanized. Also, one may notice that the catch in the muscle persists for some time. Here are a few remedies that may be useful in some people. -Using a local warm compress to heat the area-Gentle massage of the area to reduce pain-Stretching of the muscles in the back-Taking a warm shower-Icing the area for 15 mins and using a warm gel pack for 5 mins-Using a local OTC painkiller spray or gel over the area hope this helps. Do reach out if you have more questions. All the best.
Answer the following medical question in a clear and concise way.	I started feeling spasms on my left jaw and was a little swollen but then I also started feeling a very discomforting feeling on my left temple I feel like movement that comes and goes and recently felt that same feeling in my torta and chest it happens everyday for the past month and a half there are times where I feel it get worse I been feeling very tired and feel like I cant concentrate on my daily duties .	Thanks for your query, I have gone through your query. The pain and swelling could be because of the gum infection over the wisdom tooth (periodontal infection leading to space infection). Consult an oral physician and get a radiograph done to rule the amount of space present for the tooth to erupt if space is there for the tooth to erupt then the gum covering over the wisdom tooth can be removed. If the space is not available then you have to get the wisdom tooth removed. Meanwhile you can take a course of antibiotics like amoxicillin and metronidazole (if you are not allergic). Do saline gargling. I hope my answer will help you, take care.
Answer the following medical question in a clear and concise way.	hi.. i ve been taking pills since july 2012, i was using azul, but last month, february , i changed my pill to althea, and i took the first tablet even if i was done with my menstruation . it was stated on the instructions that it s ok to start the pill at any day as long as you follow the days indicated on the pill pack. but on the first week that i was taking the pill i was also taking antibiotics/antibacterial named amoxicillin . and i had made out with my boyfriend on the 5th day that i was taking pills. i finished my 21st tablet last march 2 and it s already march 6 today and i still don t have my period. the last day of my period was jan. 30.. i did some research and it says that antibiotics don t interfere with the pill except the one named rifampin. so i m confused, am i pregnant? pls help me. -AAAAAAA. stressed out-	Hello, Thanks for posting, Well I do not think you are pregnant if you have been taking the pills as indicated even though it will be wise to conduct a pregnancy test in about a weeks time just to be sure that pregnancy is not the cause of your amenorrhea. Pills are hormone based and can alter the concentrations of your natural hormones there by leading to menstrual irregularities. Since you changed abruptly your initial birth control and introduced a new one, it is possible that it is the change that lead to this. Menstrual irregularities e.g., spotting, breakthrough bleeding or amenorrhea can occur during its use. Most of these side effects are mild and usually disappear after a few months of contraceptive use. So I suggest you worry less than stress on its own can lead to menstrual irregularity. Hope this helps
Answer the following medical question in a clear and concise way.	i am 42 year male and having blood pressure of 150/95 today morning at 10.30ama)should i start any medicine or cardio/brisk walks would be good?b)can bp medicine once started be stopped in future?c)is it true that morning bps r higher than evening ones?	Hello and thank you for using Chat Doctor. I carefully read your question and I understand your concern. I will try to explain you something and give you my opinion related to your questions. You should know that we talk about hypertension if we have mean values above 140/90 mmHg. We can not judge if we have hypertension with one only value. A person might have high blood pressures after a physical or emotional stress, so it is mandatory to judge on mean values, during all day. Hypertension is divided in two groups: The fist one is Essential hypertension, without an identifiable cause, usually in older ages. It is a chronic disease that does not have a cure, but it should be treated all live. Once it is diagnosed, it should be treated always with medicine. The other group is secondary hypertension meaning that it is a second disease causing it, that might be renal, endocrinological or cardiovascular anomaly. Resolving the causing pathology might resolve the hypertension. So, the first thing to do in your case is to know if we really are dealing with hypertension or not. The second one is to know what kind of hypertension is it and then we can judge how to treat it. If I was your treating doctor I will recommend a blood pressure holder monitoring to have a full view of your values, during day and night. During mornings people have bigger activity and for this might have higher blood pressure values. I will recommend a cardiac echo to evaluate heart anatomy. After this a fool blood check up, your urinary catecholamine and an abdominal echo to see the renal situation. Only after this we can know how to treat your hypertension. If you have high values they should be treated with medications. Physical activity is not good if you have uncontrolled high blood pressure values, because during activity the values rises even more. It is necessary to start treating it and then start physical activity. If it is essential hypertension you will treat it all live. Hope I was helpful. Wish you good health. Best regards.
Answer the following medical question in a clear and concise way.	Hi please can you help me I got both my lower wisdom teeth removed two years ago I suddenly got a very sharp pain at the back of my jaw line it hurts when I open my mouth and when I eat it also feels like its hurting my ear aswel but it doesnt feel like tooth ache it feels like I have been hit on my jaw but I havent had any incidents	Hello, Thanks for consulting Chat Doctor I have read your query. Sharp pain in jaw line can be due to Temporomandibular disorder. For this I will suggest you to take soft diet. Avoid excessive mouth opening. Do Hot fermentation. You can take medicine Muscle Relaxant like MySpace forte or Flexion MR by consulting with local doctor. Consult oral surgeon for clinical examination of TMJ and investigation like TMJ sectional view. Hope this will help you. If you have more query feel free to ask I will be happy to help.
Answer the following medical question in a clear and concise way.	When ever I take a large gulp of water I can feel it going down my throat and into my stomach. Suddenly as i am breathing normally a bad smell araises from what i think is my stomach. I sense the smell when I exhale. It stays for a little while and then goes away until i take another gulp of water. Until now i dont notice it when i drink anything else. Only with H2O. This is something thats been happening to me recently. How come???	HI. The smell which you are getting from the abdomen while Chat Doctor. Another reason :This is called Foe tor in medical language. You have a history of blockage of one nostril. SO this can be Due to Chronic Sinusitis, the sinus can have pus which gives you the feeling of Weird smell. I would advise you to have a consultation with an ENT Surgeon, get Clinical examination done; CT scan of the Sinuses and an X-ray of the chest is mandatory. Get the treatment according to the reports. IF the CT scan is normal we can consider the possibility of a problem in the Sensory System and you may need an opinion of a Neurologist.
Answer the following medical question in a clear and concise way.	For many years I have suffered from back pain. I have a tilted pelvis and have suffered from sciatic nerve pain which is now under control. While I am able to maintain my lower back issues with specific exercises, walking and sometimes anti inflame medication, for the last couple of months I have been experiencing middle back pain. It feels very tight around the rib cage area. Most pain is felt when I am lying down.	Dear Friend, Thanks for contacting Chat Doctor. There are three ways pelvis can tilt. Anterior/Posterior/Lateral. Which one is yours? For all three the choice of exercise has to be different. You might not be doing the right exercise that is why your pain is getting chronic. Middle back pain could be because of bad posture, could be kyphotic. You need to check the length of pectorals major muscle, if short you need to stretch it. Thanks
Answer the following medical question in a clear and concise way.	I m a 20 year old male I started smoking about 10 ciggarettes a day from the age of 15-20 (quitting slowly) and was around 5 11 at 15 so kinda had a growth spurt while smoking, my dad is 6 0 and mum is 5 6 and older sister is 5 10 and older brother 6 2.5 and I m only standing at 6 0.5, I also didn t eat too much at around 16-17 due to anxiety and was put on anti-depressants from 17-19 and they are shown to stunt growth from studies, as well as smoking. ( i didn t know at the time ) not too sure how much I grew but from what i ve gathered ive grown around 1.5-2 inches from the age of 15 to now. I have a similar body to my brothers but just skinnier and shorter oh and my armspan is 3.5 inches shorter than my height and from studies again have said they should be the same length or longer. Online height predictors say I would be 6 1-6 2 but i m soo confused! So this is why i would like to ask a professional on the matter. Thanks.	Degree understand your concerns went through your details. I suggest you not to worry much. I can conclude from the description that your anxiety is clearly due to unnecessary thinking. You can think about your health but not excessively. Every people living on this earth have some cosmetic problems on their body. They always neglect those problems mainly because they have something better to do. Don't you have anything better to do other than thinking about your build, height and arm length? Please concentrate on your education and career. Leave other factors to the nature. 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.
Answer the following medical question in a clear and concise way.	Hello Doc, Our baby is born on Aug 1st and birth weight is 4Kgs. On 15th we had a check up done and found that his weight is 3.6 Kgs. Doctor has prescribed Dexolac (30 mg daily/once) now. Please advise me is it safe to give to a 19 days old baby and are there any side effects?	Hi, Thank you for asking question on Chat Doctor. Breast milk is the best milk for the baby. It is usual for the babies to lose weight during first 1-2 weeks. I do not understand what for you want to introduce Delay. At present your babies weight is normal, and definitely it will increase as the days pass by. Hope this answer will serve your purposeless feel free to ask any more queries if requiredTake care Chat Doctor. V. Subrahmanyam MD;Disassociate professor of pediatrics
Answer the following medical question in a clear and concise way.	I had a light pink spot on my right cheek near the two back tooth at the top,it has been swollen for about 7 weeks now doc told me to use warm salt water it didn t work now it hurts bad went back to doc they prescribed chloraseptic mouth wash no pharmacy had it but they gave me corsodyl mouth wash using it now but no result yet jus give me tooth ache since I start using it can somebody tell me water wrong	his u said a pink spot on your right cheek. Is the cheek is swollen, or the pink spot is swollen ? If the cheek is swollen it would be the upper third molar which is hurting your cheek. This will give u a mild swelling on that side. In case your in any of your teeth is decayed and if it is infected there are chances of swelling in that particular side. In case if u have third molar which is hurting the cheek due to lack of space to erupt this problem arises. And as u said about the pink spot on cheek will arise in continuous mastication forces on cheek. In this case grinding of that particular teeth for temporary relief or extraction of that teeth in case third molar will give you're leaf. Following painkillers and a topical gel like McCoppin or colonel. So kindly consult your dentist and get the needful treatment done. Take care Chat Doctor.
Answer the following medical question in a clear and concise way.	iam 19 year old female and Tubercular Lymphodenitis was detected by the needle test of lymph nodes in my leftside of neck some 4 months back.doctor advised me to take AKT4 . im still in the treatment taking the medicines for the past 4 months.inspite taking the medicines another growth lump is found on the right side of the my neck too.is the treatment iam taking is right? or should i change...kindly guide me..	Hi, thanks for writing to Chat Doctor and sharing your persistent health concerns! Well, this is common and nothing but infection by an unusual or atypical strain of tuberculous bacteria which is common now-a-days! The bacilli are resistant to classical or routine anti-tubercular medicines and generally the patients need a personalized therapy under strict medical supervision! I would further suggest you to go for ACTED CULTURE FOR AFB WITH CULTURE/SENSITIVITY TESTS to determine the definitive medicines appropriate in your case! Hope this answers your question. If you have additional questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health.
Answer the following medical question in a clear and concise way.	I was recently diagnosed with HSV-1. However, I am asymptomatic. Therefor, I am unsure of where the virus is active, genitals or orally. Is there a way to know where I am infected, seeing as no lesions have been present? Also, how would I know if I am shedding the virus without lesions?	Hello, Thanks for posting on Chat Doctor, Most at times, Herpes Simplex Virus-1 (HSV) infection presents with no symptoms as in your case and may remain so for a very long time. It usually manifests more often in a state of immunosuppression of the host. If symptomatic, you will develop cold sores. However, it is a very contagious sexually transmitted infection, and unfortunately you might not be able to tell when you are transmitting or not. Medications can reduce the duration and frequency of herpes outbreaks. They can also help reduce the risk of HSV type 1 transmission to a susceptible partner. These medications are mostly antivirals such as acyclovir (prescription only Chat Doctor. Hope this helps
Answer the following medical question in a clear and concise way.	55 yr old female. I have been having pain in the upper right abdominal area under and below ribs also to the back - 4 days now. The pain is worse when I burp or hiccup (diaphragm spasms?). Deep breaths also are difficult. Pain sometimes radiates or refers to the collar bone area.	HI. Thanks for a perfect book-picture type symptoms you have noted. There is an inflammation of the Liver and / or under-surface of the diaphragm. The most common cause of an abscess in the upper part of the liver. Another causes are irritation on the diaphragm by abscess. There is a possibility of a Cancer of the liver. This is also causing the referred pain to the collar bone area, worsening on burping or hiccough. I would advise the following:Blood tests - routine, WBC for infection, blood sugar to rule out diabetes. Kidney functions, liver function to determine the damage to the liver. Urine StoolUltrasonography to start with and may be necessary as a guidance for biopsy and / or aspiration of the abscess / mass. CT scan to confirm and to plan the treatment.
Answer the following medical question in a clear and concise way.	Hi, I have a bump on the front left side of my gums, about half way up. It is a small bump and it has a smaller white head at the top of it. It is a little painful when I eat, and it feels like something is pushing against my gums when food, touches it. And it is sore to the touch. What is this?	Hi. Welcome to Chat Doctor. I read your query. The bump you mentioned on the gums correlate with abscess in your gum and the white point is the point of pus discharge that has formed. Check if corresponding tooth have cavity, which can be even on inner surface of teeth or in between two teeth. Or this could be due to trauma like hitting corresponding teeth or biting something hard from those teeth suddenly. You need to visit a dentist and get an x-ray done for definite diagnosis. It may require RCT of tooth. Do warm saline rinses. Take antibiotics and painkiller prescribed by dentist after check up. Permanent treatment is to get Chat Doctor. Hope the answer helps you. Thank you.
Answer the following medical question in a clear and concise way.	What are the treatments for Fuchs endothelial dystrophy ?	These resources address the diagnosis or management of Fuchs endothelial dystrophy: - Duke Eye Center: Corneal Disease - Genetic Testing Registry: Corneal dystrophy, Fuchs endothelial 1 - Genetic Testing Registry: Corneal dystrophy, Fuchs endothelial, 2 - Genetic Testing Registry: Corneal dystrophy, Fuchs endothelial, 3 - Genetic Testing Registry: Corneal dystrophy, Fuchs endothelial, 4 - Genetic Testing Registry: Corneal dystrophy, Fuchs endothelial, 5 - Genetic Testing Registry: Corneal dystrophy, Fuchs endothelial, 6 - Genetic Testing Registry: Corneal dystrophy, Fuchs endothelial, 7 - MedlinePlus Encyclopedia: Fuchs Dystrophy These resources from MedlinePlus offer information about the diagnosis and management of various health conditions: - Diagnostic Tests - Drug Therapy - Surgery and Rehabilitation - Genetic Counseling - Palliative Care
Answer the following medical question in a clear and concise way.	hellow doctor, i am 21 year old female, suffering from severe headache, and chest pain from past 2 weeks. i had gone to the hospital and consulted the doctor and they have given the medicines also.. as per their medicines one medicine name is NEXPRO RD 40. and i would like to know that y it is used.. and for what reason i would like to take that medicine.. and what is side effect of that medicine.. plz i am waiting for your reply.. thank you	Hi, Nexpro-RD is a combination of a proton pump inhibitor (omeprazole) and an anti-vomiting Chat Doctor. It is commonly prescribed to treat HERD (Gastroesophageal reflux disease) and indigestion by relieving the symptoms such as heartburn, stomach pain, or irritation. It also neutralizes the acid in the stomach and promotes easy passage of gas to reduce stomach discomfort. Generally it is well tolerated by most of our patients however it may cause diarrhea, flatulence,
Answer the following medical question in a clear and concise way.	Went to dentist Tue to get four fillings filled 3 white one silver one,I started getting itchy skin my knuckles or fingers started swelling it was like this for two day on 3rd night I awoke and could barely walk the heels of my feet hurt my elbow joints,shoulder joints and hands all had very sore joints which is today,my feet are better but my left shoulder hurts elbow and hands hurt and swollen.Any Ideas? Thanks. Mike	Hi, Thanks for your query. Seems you are suffering from multiple joint pain -poly arthralgia. Other causes can be rheumatoid arthritis, gout, inflammatory diseases like SHE, bursitis, fibromyalgia, etc. For proper diagnosis, some blood tests are advisable like- 1. Serum calcium levels.2. Serum Uric acid levels.3. RA factor4. ESR and CRP5. Serum Creatinine6. X-ray of affected joints. You need a thorough clinical examination followed by investigations under the guidance of an orthopedic. Till then for symptomatic relief, you can take over the counter analgesics, do hot fomentation and apply local analgesic gel on the affected areas. I do hope that you have found something helpful, and I will be glad to answer any further query. Take care
Answer the following medical question in a clear and concise way.	I am 25,male. My problem is with my erection, it is putting me in stress so much nowadays and i am starting to suffer ED also. When agitated, it becomes thick and harder but doesn t come up(just comes 30/40degree up relative to legs direction) and get straight, its way too much curved downward(concave downward). I can take it up with hand but i want it come at least 90degree up naturally. Please help me. Suggest me some good medication.	HelloThanks for writing to us. Exercise would definitely help in Erectile Dysfunction. Exercise, especially moderate to vigorous aerobic activity, can improve erectile dysfunction. However, benefits might be less in some men, including those with established heart disease or other significant medical conditions. Even less strenuous, regular exercise might reduce the risk of erectile dysfunction. Increasing your level of activity might also further reduce your risk. Discuss an exercise plan with your doctor. Take Himalaya confide tablet for ED. It will help you. It's a herbal product and has no side effect. I hope this is helpful to you. Regards
Answer the following medical question in a clear and concise way.	Hi, Im 22yrs of age the gynae ive been to diagnosed me with (PSOS) and i have irregular period. He put me on ovral 28 and it did not work for me. however my husband and i would like to have a baby i feel much better ever since i stopped taking the contraceptive. I would like to know if i can fall pregnant because ive been struggling to and ive seen so many doctors and none of them are able to help me	Hi, I think you can get pregnant. If your periods are regular, be in contact with your husband every 2 to 3 days after your periods stop. It will increase chances of your pregnancy. If your periods are irregular, then there can be a problem of ovulation. So, then you can take some medicines like camphene for the growth of your follicles and track your follicles' growth by repeated ultrasound and when your follicles is more than 17 to 18 mm, take injection for rupturing the follicles. Be in contact with your husband for 2 to 3 days after injection. Take progesterone for next 2 weeks. Do a urine pregnancy test at home after that. You can try like that for 3 to 6 months.
Answer the following medical question in a clear and concise way.	Friends husband with enlarged spleen and liver, fever as high as 104, headache with only the edge taken off by Vicoden and fatigue x 1 wk (lyme negative, spinal tap done for meningitis, blood cultures done and pending). Head CT negative. Only taken to small community hospital - West Nile Virus and Rocky ? Spotted fever	Hi and welcome to Chat Doctor. Thank you for your query. I am Chat Doctor, I understand your concerns and I will try to help you as much as I can. Enlarged spleen is called splenomegaly and there are various causes possibly leading to this. In first case these are infections such as mononucleosis Parasitic infections, such as toxoplasmosis or Bacterial infections. It means that any infection in your body may lead to spleen enlargement. Second most common causes include autoimmune diseases such as thrombocytopenia. If this is ruled out by specific tests then some other causes may be considered and some are more or less serious such as Leukemia Lymphoma, or noninflammatory diseases such as acidosis, lupus, and rheumatoid arthritis. In every case, infectious causes are treated with antibiotics and other causes may require surgical removal of spleen. I hope I have answered you query. If you have any further questions you can contact us in every time. Kindly regards. Wish you a good health.
Answer the following medical question in a clear and concise way.	Hi, in September i originally had pain in my lower back and left testicle. I chalked it up to doing alot for my wedding. Now I still have those and groin and thigh pain and now my big toe is numb. I just started a new job and wont have insurance until the new year. Any idea whats going on and can I wait till I have insurance to see a doctor. Thank you. Bob.	HIT hank for asking to ChatDoctorLook this kind of pain is usually due to testicle inflammation called orchids simple NSAID gives good result right now I would advise you to take Diclofenac 100 mg just one tab in day in sustain release form, the numbness of toe is nothing to do with this could be something else for that clinical examination is must, I would advise you to first rid of your testicle problem meanwhile the numbness of toe may go away, have nice day.
Answer the following medical question in a clear and concise way.	Looking for interpetation of MRI report in laymans terms. Impression: Central and right lateral disc herniation at L5/S1 which has increased since prior study and now effaces the ventral thecal sac and narrows the right neural exit foramina. This abuts the exiting nerve root on the right . Next L3/L4 moderate facet hypertrophy . mild diffuse disc bulge present. Congenital shortening of the pedicles. no spinal stenosis. Mild narrowing of the neural exit foramina right is greater than left.	Hello Report suggests degenerative disc disease of lumbosacral spine. Degenerative changes occur in spine due to aging and development of weakness in annulus fibrosis.1. At L5-S1 level, there is disc herniation in central and right lateral region. Findings has been increased in severity as compared to previous study, and it is now touching the ventral thecal sac. Herniated disc is also abutting right exiting nerve roots.2. At L3-4 level, there is moderate facet(bony joints in between two vertebra) hypertrophy. There is also mild diffuse disc bulge present with congenital shortened pedicles. There is mild narrowing of lateral neural foramen. Majority of the cases of degenerative spine disease are benefited by physiotherapy, so you should try it first. Surgery should be the last option. Treatment can be planned after consultation with neurologist. Get well soon. Take Care Chat Doctor.
Answer the following medical question in a clear and concise way.	I am suffering from back pain and had consulted a MS ORTHO..He gave me testing of MRI of DORSAL SPINE. Which has an impression as"Altered marrow signal intensities of D7, D10, D12 and L5 vertebral bodies with well defined lesions in these vertebra as well as in right sacral promontory. Following possibilities are to be considered - ? multiple myeloma ? metastasis."AndMANTOUX TEST which gave an impression asInduration - 20 mm" Positive. Induration measuring 10mm or more indicates hypersensitivity to tuberculoprotien and indicates past or present infection with mycobacterium tuberculosis""Doubtful. Induration measuring between 5 and 9 mm indicates desirable to rule out cross reactions from other mycobacterial infections""Negative. Induration of less than 5 mm indicates lack of hypersensitivity to tuberculoprotien and tuberculous infection is highly unlickely."AndThe ESR (Westergren Method) was 90 mm/ 1st hr.Now am totally confused and the back pain is totally unbearable...	Hi, Welcome to Chat Doctor. After going through your query, I think you are suffering from metastasis or multiple myeloma with rare possibility of tuberculosis. You can go for CT guided NEEDLE biopsy. Treatment consist of pain relief by strong analgesic(such as attract three times a day after meals) OMEPRAZOLE 20 MG before meals prevent acidity caused by analgesics. SPECIFIC TREATMENT WILL BE after biopsy report. I think your query answered. Welcome to any follow-up query.
Answer the following medical question in a clear and concise way.	I have suffer from depression for the last 15 years my Dc. Gave mirtazapine of 15 mg how ever I have doctors in my family and they gave me alprazolam 1 mg and I would like to know the difference dou to my sleeping and depression that prescription is not helping me	Hi, Mirtazapine 15 mg is a right medication. Alprazolam is a sleep promoting medicine with anxiolytic property, but it can not have potential to treat Depression effectively. I advise you to continue tab Mirtazapine as it may treat Depression and at the same time, due to sedative property it may be helpful in promoting sleep. After few weeks of therapy you may feel the difference, but you must continue the Chat Doctor. All the best.
Answer the following medical question in a clear and concise way.	I take nexito4 twice daily in the morning and night for For the last 6 years and have gained considerable weight which I feel is a side effect of this medicine.kindly suggest me a method or a substitute where I can keep a check on my weight gain .i have tried several times to do without this medicine resulting in depression .thanks and regards u.d	Hello Next or Escitalopram causes gain in weight, but it is not much significant in clinical practice. In a lot of people who are suffering from depression, hyperplasia may be seen, and it causes weight gain. As have mentioned you have gained considerably. Best thing you can do is go for brisk walking daily. It will not only decrease weight but will also check the depressive symptoms. If any need in dose of medicines occur then visit your psychiatrist. Thanks
Answer the following medical question in a clear and concise way.	Hello Dr my partner has got big red sore lumps on his face and head and has been given Flucloxacillin 500mg he has taken 7 tablets so far is it safe to drink alcohol with them ? as it does not say on leaflet .How long should it take to see an improvement? .	Hi. Thanks for your query. Noted the history about your friend who has got big sore lumps on his face and taking Flucloxacillin 500 and now wants to know whether Chat Doctor. . As per the history you have given about your friend, alcohol surely will increase the already existing lumps on the face and can worsen the problem. Also, alcohol can interact with many other things including Flucloxacillin, hence should not be given. If you had provided the photos I would have been in a position to give him further advise.
Answer the following medical question in a clear and concise way.	I have had pain in my lower right abdomen for about 5 weeks now. 5 weeks ago I went to the emergency room because they thought it may be my appendix but it was just lose fluid, but they didn t know what kind of fluid. The next night we went back and they checked my blood and said nothing was wrong but they didn t take another xray or anything. I do have anxiety and I have had stomach aches from that before but this is different before it was an ache in the center of my stomach like butterflies but now this time it is in the lower right of my stomach and it is now starting to be slightly on my left so I was just wondering if you could think of any main things it could. thanks	Hi. Thanks for your query. Your history is rally classical as if from the text-books. The pain had been in the center of the abdomen and shifted to the right lower abdomens is very classical of appendicitis. Appendicitis, even though a common surgical problem can present in many forms and is really very difficult in many cases. Usually a high resolution ultrasonography helps in a diagnosis and CT scan is confirmatory in almost all the cases. I would advise seeing a Gastroenterologist and request for a CT scan of the abdomen to get a proper diagnosis. If this is appendicitis, you have to undergo appendectomy operation as it is already late. Left sided mild pain can be due to spread of infection to this part of the abdomen.
Answer the following medical question in a clear and concise way.	hi i have recently had pregnant symtoms i m sick every morning my breast have bin leaking clear fluid bin moody and i m soo tired i had a period on the 9 of jan but it wont like my normal period it was light brown/red i took 2 hpt last week they was neg then on sunday i did 1 it took 5 mins for the lines 2 show one of them was faint i show my partner because i thought it was my eyes playing tricks but it wont he saw it then 15 mins later the faint line had gone i m pregnant?	Hallow Dear, The bleeding which you had was very little and the pregnancy test showing faint line suggesting weak positive test sends a signal of alarm that you have to get ectopic pregnancy ruled out. The weak positive test may be false positive, however considering the seriousness of ectopic pregnancy, it is better to err on safer side and get investigated for ectopic pregnancy. Ectopic pregnancy is a pregnancy implanting outside the uterine cavity, most commonly in the tubes. Such pregnancy cannot go to the term and may rupture causing alarming intra-abdominal bleeding necessitating surgical intervention with blood transfusion. Please report to your Obstetrician to clarify the situation. I hope this sends you the required message.
Answer the following medical question in a clear and concise way.	I have a sharp pain on the right side of my chest that goes all the way through to my back. Sitting here not moving and breathing normal, it is just a uncomfortable feeling but when I breath in deep or move my head to the left and right, like youre warming up for exercise, the pain gets increasingly sharper and almost puts me in tears! What is it and how can I fix it?	Thanks for your question on Chat Doctor. I can understand your concern. By your history and description, possibility of pulled muscle is more likely. So avoid movements causing pain. Avoid sudden jerky movements and neck and chest. Avoid heavyweight lifting and strenuous exerciseApply warm water pad on affected areas. Take painkiller and muscle relaxant Chat Doctor. 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.
Answer the following medical question in a clear and concise way.	Good afternoon doctor. we are trying for a baby since 8 months. i have mild pcos and my husband less count. i.e. 43millions . doctor suggested him to take fertisure and me glycomet, cabergoline. again we consulted one more doctor who just gave medications for me . i.e folinine and berocin . do we have chances this time? is my husband can improve his count? since its affecting our phy relation? thanks in advance	Dear member, Thanks for writing to Chat Doctor. I am Chat Doctor. Consultant organ specialist. I can understand your anxiety as infertility treatment requires lots of patience. If pics is mild it can be treated with weight loss and tab Ginette 35. The glycogen has to be taken regularly, and a diet has to be followed according to BMI. The husbands count of 43 millions is ok if motility is good. The treatment for you will be ovulation induction. In my clinical practice I have noticed that mild PCs can be treated easily if you have patience and show discipline in diet. Please call back with reports to
Answer the following medical question in a clear and concise way.	Hi, I got my Montoux test done whicChatDoctore positive. my GP in UK said a blood test is needed to confirm . Blood test is now positive but I dont have any symptoms of TB. I am scheduled for IVF treatment sometime from June to Aug. Could there be a possibility that the doctors in UK may postpone the IVF Treatment until they completely kill TB. They have not shared with me what kind of TB I have or even if I have latent TB or any other advanced TB? Query is - does by any chance if I got TB then would it interfere with IVF?	You would need to postpone IVF if you have TB and receive treatment. At the minimum you have latent TB or a past exposure. They may get a chest X-ray and sputum tests to see if it is active or if there is evidence for a previous infection. The treatment for TB (both latent and active TB are treated) entails several antibiotics for a prolonged period, so you would not want to be carrying a child during that time. Additionally, pregnancy makes you more susceptible to infection, so even if its latent TB, pregnancy might allow it to become active. So you do need to wait and be sure the TB is cleared from your system before you do IVF. Hope this helps.
Answer the following medical question in a clear and concise way.	my husband has been having tingling/numbness in his hands and feet .... and his arms....almost as if he has slept on them and you get that tingly feeling. he hasn t really felt right since June....very light headed....has had to pull over when driving... the right side of his face has now started getting prickly now. 2 weeks ago he went to the doctor and she thought the tingling/numbness and the light headedness/dizziness are not related. she ordered blood work but they called and said it all was normal. she ordered a neck xray (thinking maybe a pinched nerve)...we haven t gotten the results of that yet. the past 2 days he has felt worse.....nausiated and hot flashes... last night, he woke at 4am and said his heart was racing and he just didn t feel right - his left arm was tingly again.	Hello, In my opinion, neurological conditions such as Chiara malformation, peripheral neuropathy, etc. should be considered as possible conditions that may cause such symptoms. The first step in achieving a correct diagnosis is a careful neurological examination. Tests such brain and neck MRI, nerve conduction study, are also necessary. Discuss with your husbands Neurologist for these issues. Hope I have answered your query. Let me know if I can assist you further. Take care Chat Doctor.
Answer the following medical question in a clear and concise way.	Hi, My Son complaint of sever pain in his chest. He said he had the worst cough so far and following that he had this pain and then itching. He has had asthma issues and we observe there is some complication with him lung which no doctor has yet diagnosed.He is 14 years and 82KG. I am just worried what could be wrong and how this could be treated?	Hi welcome to Chat Doctor... Noted you have diagnosed with asthma ... It is allergic condition in which patient having hypersensitivity to certain allergen... For confirmation pulmonary function test done... If repeated asthma attack occurs then Metered dose inhaler like long acting palmetto or foretell with steroid needed.... As asthma allergic condition itching can occur by histamine when exposed to allergen... Try to identify allergen or do allergy test ad keep exposure to it minimum... Your child also overweight ... Reduce his weight ... As obesity create problem in breathing... Passive smoking exposure avoided... Onion having anti-inflammatory action. So take cooked onion ... Take care.
Answer the following medical question in a clear and concise way.	my girlfriend and i are trying to conceive through home pregnancy, our donor lives around 20 miles away, we go and collect the sperm and bring it home to inseminate it. can you give us any advice on the survival of the sperm or any tips to ensure it is inseminated correctly?	HelloThanks for query. You have been trying artificial insemination at home. Normally sperm survival time is one hour after ejaculation. Since you are carrying your friends' semen from his place which is 20 miles away it is most likely that all sperms are dead before you reach at home. Second important aspect to be observed is that artificial insemination has to be carried out in a most sophisticated clinic under ideal antiseptic precautions by a qualified Gynecologist during a period of expected and confirmed ovulation. This is something that should not be carried by patient herself at home. Chat Doctor.
Answer the following medical question in a clear and concise way.	hi sir i am aslam i am 21 year old i lose my sperm in night after one day. while my penis not stand but i lose sperm in sleeping.. i am losing my weight. because of these pain in my legs. dark circle. headache......give me solution how to control this	HIT hank for asking to ChatDoctorI really appreciate your concern your history is suggesting that you need some basic knowledge regarding the body functions particularly physiology so can learn something let me tell you, the actual term is "Nocturnal ejaculation" for which you used the slang word "Night fall" again the real word is "Erection" for that you used the word "stand" third it is "Semen" and not the "sperm" actually semen contains the sperm, now forget the history that you told here this is complete myth, hope this helps you take care and have a nice day.
Answer the following medical question in a clear and concise way.	hello gud day tou dr. im naty from philippine. i had a blood test yestday the result areWBC13.0.RBC5.31,HGB15.4,,HCT44.1,,MCV-83.1,,MCH29.0,,MCHC34.9..PLT277..they said my hemoglobin is high pls advise how to decrease my hgb.. is this all test is normal i didnt go yet to the dr?? tnx	Hi, dairy have gone through your question. I can understand your concern. Your hemoglobin is normal. No need to worry and no any treatment is required for that. Your WBC count is slightly high. You may have mild infection. If you have any symptoms then take antibiotics accordingly. Your rest all reports are normal. 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.
Answer the following medical question in a clear and concise way.	Im experiencing brown spotting. My menses ended last Saturday. My boyfriend and I were making love with our underwear on. But we did rub our parts against each other and he did finger me. All with our underwear on. However the spotting only occurred after 2 full days. Why is this so? And what does it mean?	Hi. At times a sexual encounter, even without penetration can cause hormonal fluctuations which can result in the presentation you are experiencing, but there are numerous other factors also that can cause such a presentation like stress, weight fluctuations, side effects of medications, birth control, etc. So please discuss the details with your doctor or write to me using our premium service. Best wishes.
Answer the following medical question in a clear and concise way.	Hi Doctor, I feel discomfort mostly at night, I can t sleep because I can hardly breathe. Its as though something is blocking my airway in my throat. It moves up and down my throat as as if there is bronchial mucus in the throat I can t seem to bring out yet its blocking my throat. Thanks.	Thanks for your question on Chat Doctor. I can understand your concern. Breathing difficulty especially at night is commonly seen with asthma. So better to consult pulmonologist and get done 1. Clinical examination of respiratory system 2. PUT (pulmonary function test). PFT is must for the diagnosis of asthma. It will also tell you about severity of the disease and treatment is based on severity only. You may need inhaled bronchodilator (formoterol or albuterol) and inhaled corticosteroids (ICS)(budesonide or fluticasone). Oral combination of antihistamine (levocetrizine or fexofenadine) and anti-allergic (montelukast) Chat Doctor. Don't worry, you will be alright. First diagnose yourself and then start appropriate treatment. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.
Answer the following medical question in a clear and concise way.	My child has tuberous sclerosis . He has brain tumours an epilepsy , but since yesterday I have noticed that he s unable to look up an seems to have stiffness on the right side of his neck , he cannot tilt his head back to look at objects and gets upset when I try to get him to look up. He hasn t got a high temperature an is in good enough form	Hi, Thank you for posting your query. The current problem seems to be a local neck problem, and is most likely not related to tuberous sclerosis. It could be spasmed of neck muscles, leading to pain, stiffness and restricted neck movements. As of now, you can apply local analgesic cream and take him for physical therapy. It should improve in a few days, if not better, you may take him to the doctor. Best wishes, Chat Doctor.
Answer the following medical question in a clear and concise way.	my daughter LMP 12jan2014 on 19 feb her bChatDoctor is 1608 and on tv sonography gestational sac is 6mm in size and is empty---she use to have spotting .27feb bChatDoctor is 79.8ml/iu and usg on 28feb is showing gestational sac is 7mm and irregular margins and still no foetal pole is visible. her dr. prescribed synthetic progestron 10mg bd on 19feb after tv sonography.what should we follow	Hi. Please go ahead with the progesterone and for no reason discontinue it as it will help sustain the pregnancy if at all there is any risk. Follow up in about 10-14 days (2 weeks time) for a repeat ultrasound to check on the viability of the pregnancy. I wish your daughter loads of luck and hope she gets through this pregnancy in a safe and healthy manner for both your daughter and her child. Best wishes.
Answer the following medical question in a clear and concise way.	I have ILD?? and on low dose of sterroid emsoulne tablets 0.5 mg alternate days an Luminac and assurans (Sidanafill citrate) tablets daily. As I have breathing difficultires dr advised me be on oxygen therapy is it very essential to take oxygen therapy or can I postpone mentally i am unable to decide i am confused I am a life science postgaraduate and professionally worked in medical and life science databases hence I know pretty weill about my health condition	Thanks for your question on Chat Doctor. I can understand your concern. OLD (interstitial lung disease) is chronic progressive lung disease in which lung tissue is replaced by fibrotic tissue. This fibrous tissue does not function well. So main function of lung (provide oxygen to the body) is hampered. And hence body remains oxygen deprived and cause worsening of symptoms. So supplemental oxygen is the best treatment for OLD. Supplemental oxygen will reduce your suffering, symptoms and improves prognosis and quality of life. So better to start supplemental oxygen therapy along with other Chat Doctor. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.

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